We’ve posted a “Consumers Guide to Healthcare Reform” by Kaiser Health News’ reporter Phil Galewitz. In his article he touches on some of the questions you raised in you comment:

Q: I’m over 65. How will the legislation affect seniors?

A: The Medicare prescription-drug benefit will be improved substantially. This year, seniors who enter the Part D coverage gap, known as the “doughnut hole,” will get $250 to help pay for their medications.

Beyond that, drug company discounts on brand-name drugs and federal subsidies and discounts for all drugs will gradually reduce the gap, eliminating it by 2020. ‘

That means that seniors, who now pay 100 percent of their drug costs once they hit the doughnut hole, will pay 25 percent. Beginning in 2011, drug companies will be required to give a 50 percent discount on brand-name drugs for prescriptions filled in the doughnut hole.

And, as under current law, once seniors spend a certain amount on medications, they will get “catastrophic” coverage and pay only 5 percent of the cost of their medications.

Meanwhile, government payments to Medicare Advantage, the private-plan part of Medicare, will be frozen starting in 2011, and cut in the following years.

If you’re one of the 10 million enrollees, you could lose extra benefits that many of the plans offer, such as free eyeglasses, hearing aids and gym memberships.

To cushion the blow to beneficiaries, the cuts to health plans in high-cost areas of the country such as New York City and South Florida — where seniors have enjoyed the richest benefits — will be phased in over as many as seven years.

Beginning this year, the law will make all Medicare preventive services, such as screenings for colon, prostate and breast cancer, free to beneficiaries.

Q: How much is all this going to cost? Will it increase my taxes?

A: The package is estimated to cost $938 billion over a decade. But because of higher taxes and fees and billions of dollars in Medicare payment cuts to providers, the package will narrow the federal budget deficit by $143 billion over 10 years, according to the Congressional Budget Office.

If you have a high income, you will face higher taxes. Starting in 2013, individuals with earnings over $200,000 and married couples earning more than $250,000 will pay a Medicare payroll tax of 2.35 percent, up from the current 1.45 percent. In addition, high-income taxpayers will face a 3.8 percent tax on unearned income such as dividends and interest over the threshold.

Starting in 2018, the law will also impose a 40 percent excise tax on the portion of most employer-sponsored health coverage (excluding dental and vision) that exceeds $10,200 a year for individuals and $27,500 for families. The tax is often referred to as a “Cadillac” tax.

The law also will raise the threshold for deducting unreimbursed medical expenses from 7.5 percent of adjusted gross income to 10 percent.

The law also will limit the amount of money you can put in a flexible spending account to pay medical expenses to $2,500 starting in 2013. Those using an indoor tanning salon will pay a 10 percent tax starting this year.

Galewitz’s full article is posted on LocalHealthGuide’s home page.

I’ll forward your query to Mr. Guppy.

However, the Kaiser Family Foundation, a usually reliable source, has posted material explaining the new law.

Here’s the link to the site: http://healthreform.kff.org/

Here’s a link to a PDF one summary: http://www.kff.org/healthreform/upload/8061.pdf, which includes a section on the law’s impact on Medicare beneficiaries.

My understanding is that while the law does do away with the Medicare Advantage program, it also closes the prescription drug “donut hole” and puts the whole program on sounder financial footing. (Though I’m sure there are those who will debate that last claim.)

Here’s a link to the full text of the act (if you really want to read the whole thing!): http://dpc.senate.gov/dpcdoc-sen_health_care_bill.cfm

(The text of the law was available online in its various forms throughout the recent debates, belying claims by some that we didn’t know what was in the bill.)

Hope this helps.

Best,

Michael McCarthy/Editor

We know that those of us on Medicare’s Advantage programs will be hurt seriously by it. But just how seriously is yet to be seen.

You state that the health care reform will create a new federal sales tax on real estate sales. It doesn’t surprise me that something like that might be slipped into the bill under the radar. However, I have found no other reference about it. Where did you get this information? How can I confirm it for myself?

Has the new law been published on line for the public to learn what we have actually swallowed?

Don