1. Medicare Cuts Coming.
To help pay for the bill, Medicare will see $480 billion cut from the program
over 10 years. Plus, there will be an 0.9 percentage point increase in the Medicare tax for individuals
earning more than $200,000 annually and for couples earning more than $250,000.
Medicaid will also see changes: individuals with an income level of up to 133 percent of the federal
poverty level (currently $22,000 for a family of four) will be eligible for the program.
2. Generic Biologics Established but Delayed.
The bill establishes a regulatory path for generic
versions of biologic drugs, but a provision prevents generic versions from entering the market for 12
years—about double the five to seven year timeframe initially sought. The 12-year extension seems
linked to an $80 billion agreement earlier this year by drug makers to cut prices and pay additional
taxes to help fund the expansion of health insurance coverage.
3. (Re)importation Blocked.
Drug importation and reimportaation had been heralded by some as a
means to reduce healthcare costs, but the Senate turned down a bipartisan amendment that would
have allowed for the purchase and importation of prescription drugs from other countries. Although
a majority of senators (51) voted in favor of the amendment, 60 votes were required under Senate
rules for the measure to be enacted.
4. Penalties Revised.
Per the mandate that every individual be required to have health coverage, the
bill includes hefty penalties for those who do not buy health insurance. Penalties could now be as
high as two percent of a household's income; earlier plans phased in the penalty to reach $750 by
2017 (Forbes).
5. Small Business Credits and Fines.
Under the current bill, for two years small businesses will be
eligible for credits to buy health coverage. To qualify for credits, companies must have fewer than
25 employees and an average wage of $50,000 or less. If an employer with at least five employees
does not offer coverage and at least one full-time employee receives federal subsidies to buy insurance,
that company would have to pay the annual penalty for each of its full-time employees,
regardless of how many received subsidies (The New York Times).
