This bill makes things tremendously worse, and will assure that our national and individual health care costs will continue to spiral up even faster than before.

Personally, I'm just going to pay the fine every year.  I will not give one dime to a company that profits from denying me health care services.

This is where the death panel meme comes from - claiming that HHS will be forced to cut needed medicare benefits to keep the rate of growth from exceeding the bill's limitations.  

Cost is contained simply through competition on the exchange.  If  a private nonprofit offers care for less than a private for-profit insurer, people will take their subsidies to the nonprofit.  

That's the point of the exchange.  It's like school vouchers, plus rules that make comparing schools to each other and switching to a better one easy.  The subsidies are health insurance vouchers, and the exchanges are regulated marketplaces where you can compare all the plans easily and choose the best one.

While many of the benefits don't start for 4 years, a lot of them do, including the medicaid/CHIP changes.  THOSE ARE ABSOLUTELY VITAL.  And one they go into effect they will never be repealed.  The states would go nuts if the republicans tried to make them to back to 50-50 matching.

If an insurance company or your employer denies you coverage, you become eligible to shop for coverage on the exchange.  ON THE EXCHANGE THEY CANNOT DENY COVERAGE.  A plan that denies anyone coverage on the exchange gets kicked out of the exchange - losing all those wonderful government subsidized beneficiaries.

The amount of misinformation on both sides of this bill is staggering.  I know it sounds crazy, but try to read the sections of the bill that are relevant here.  Or at least read the CBO report about the projected costs.  It's like 20 pages, and gives a great overview of the substance.

OR  we could just start over

If you had a pre existing condition  you might re think it

I dont know any bill that is perfect   and know of many that have been improved upon

But what about insurance outside the exchange - the plans employers buy for their full time employees?

First, one benefit of the bill that I haven't mentioned is that it requires employers to cover ALL employees - EVEN PART-TIMERS.  Right now, companies are scrambling to convert full timers to part time, so they don't have to pay for their health benefits.  This bill changes that - ALL employees must be covered or the employer pays a fine for each one.

But let's say the employer decides to pay the fine - it's cheaper than paying for coverage.  If your employer fails to offer coverage, you are now eligible to get insurance on the exchange.  NO DENIALS ARE ALLOWED.  You're covered.

What about paying for it?  CBO estimates that in 10 years, the bill will not only pay for itself, but will generate a $100 billion surplus.  And this is the case even if none of the future improvements to the current bill ever take place.

For people who don't get subsidies on the exchange, the government doesn't pay anything - it's still funded by premiums.

As for the increase in medicaid and CHIP beneficiaries, and the subsidies on the exchange, they're funded by cuts to medicare part D - the privatized supplemental program enacted by the Republicans during Bush.  This program has proven to be extremely wasteful, since it gives the money to private insurers who then run the program for-profit.

Huge savings also come from cutting administrative costs.  Private plans have 15%-18% administrative costs, while medicare boasts 3%.  

Finally, the surplus is money saved by giving people better preventative care throughout their life BEFORE they become eligible for medicare.  Right now, many people wait it out until they hit 65, and then dump the cost of cleaning up all their untreated illnesses onto medicare.  By insuring the uninsured or underinsured throughout their lives, medicare is no longer burdened with the cost of making up for illnesses that have gone untreated and the absence of preventative care.

if your parents don't have health insurance, the bill gives subsidies to anyone making less than 4 times poverty level.  So if you make less than $48,000 in a year, you will get subsidies to use on the exchange.  THIS IS ACTUALLY A GREAT THING - once you're on the exchange, you stay on the exchange for life, even if you get a job where the employer pays for insurance, or go to a college that offers student insurance.

If you make less than $16,000 in a year, you qualify for medicaid.  So you're covered.

This bill is the worst for people who make $50,000 and are self-employed - they don't get subsidies but are required by the mandate to pay for insurance.  This sucks, and a lot of my friends a few years out of college are stuck in this no man's land.  

But this flaw isn't enough to justify killing the bill.

How can anyone believe in a "free" market where some people are coerced to sell their labor for their very survival?

Unfortunately, the majority of Americans don't believe that.  If you figure out how to get Swedish citizenship, please let me know.  Until then, we'll have to continue trying to drag this country kicking and screamin4 toward a more humanitarian future.

This bill is like step 4 of 7452.