I received a question via email today and I thought I would share my response in case other people may have had the same question, or one very similar. Pat asked,
“I was on a conference call with Michelle Bachmann. She stated that under the provisions of the health care bill, the payments from people would begin in 2010, but the benefits would not be seen until four years later, or 2013, is this true?”
The first time I read the health care bill I did so at a “quick review” type pace. The second time I read it, I analyzed it to point out all of the sections which would affect people the most. While I quoted many costs and amounts, I never really double checked the years of collection versus the years of implementation.
While analyzing Division A and doing a search for the years in question, I found a couple references.
Section 100 defines Y1 (or year 1) of the health benefits plan as 2013 which seems to support Michelle Bachmann’s claim that people would not see any benefits until 2013. People cannot benefit from a health benefits plan before 2013 if it is not implemented until 2013.
Further review of Division A shows that the small business employee health coverage credit which will be implemented right away, will be phased out beginning in 2013. President Obama and House leaders are quick to state that the health care bill will not affect most small business owners, but that is just not true. You can read more about this “phase out” of the credit in Division A, Subtitle B, Section 421.
There could be more hidden in Division A, but in the interest of just answering the question presented, I moved on to Division B to perform the same search.
Reporting requirements for the quality of outcomes for people enrolled in Medicare Advantage plans are not required to be implemented until 2013, so any treatments or outcomes will not be subject to reporting until then. This is mentioned in Division B, section 1162.
Division B, Section 1703 also sets a deadline of 2013 for any benchmark benefit package. These packages must meet the minimum benefits and cost-sharing standards of a basic plan by this time.
Section 1802 of Division B sets the amount of funds to be transferred to the Trust Fund by year. $90 million in 2010, $100 million by 2011, and $110 million by 2012. These funds obiviously come from somewhere so, again, Michelle Bachmann was correct. We will be paying ($300 million in this section alone) beginning in 2010 while the health benefits plan will not go into effect until Y1, or 2013, as stated in Division A, Section 100.
Section 1802 also sets a “fair share per capita amount” beginning in 2013, which will be computed by the Secretary of Health and Human Services for each fiscal year which is projected to be $375 million for the 2013 fiscal year alone.
According to this same section we will be paying another $26 million for the Comparative Effectiveness Research Commission from 2010 through 2012.
Section 1904 defines applicable percentages of expenditures, itemized by year for 2010-2014, and appropriates another $300 million for the implementation of that section before 2013.
Things get much more interesting in Division C, where Section 2002 defines the establishment of funds for the Public Health Investment Fund.
For fiscal years 2010 – 2012 a total of $17,100,000,000 (yes, that’s billion, not million) shall be directed into the fund from “general revenues of the Treasury”.
Section 2101 allocates an addition $5 billion in funding for community health centers. Section 2202 authorizes appropriations in the amount of $798 million for the National Health Service Corps. $758 million will be allocated for primary care and dentistry. All of these appropriation amounts are for the fiscal years 2010 – 2012, prior to the establishment of the Public Health Benefit Plan in Y1, or 2013 and Division C goes on to authorize and allocate a lot more money from the general fund of the Treasury.
So, Pat, I hope this post helped answer the questions you had following the conference call with Michelle Bachmann. It does appear we will be shoveling a lot of money towards all of the programs defined in the health care bill for three years before any public health benefit is implemented.