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Patient Protection and Affordable Care Act Provisions:

Prohibits insurers from taking pre-existing conditions into account when determining whether tooffer coverage to an individual

Requires insurers to offer the same premium to all applicants with the same age and

geographical location (gender is not taken into account, nor are most pre-existing conditions)Establishes minimum standards for health insurance policies

Requires everyone not covered by an employer plan, Medicaid, Medicare, or some other publicinsurance plan to purchase private insurance or pay a fee (unless the individual has a financial difficultyor is a member of a religious group given exempt status by the IRS).

Establishes health insurance exchanges in states. These are online markets where policies can becompared and insurance can be bought. This is for people not covered by Medicaid, Medicare, or anemployer plan.

Subsidies on a sliding scale are implemented for those whose income falls between 100% and400% of the federal poverty level and who buy insurance on the exchanges. For example, those whoseincome is between 133% and 150% will be subsidized such that their premiums will be 3 to 4% of their income. The highest family income that qualifies for a subsidy of any sort in 2013 is $94,200.00.

Expands Medicaid eligibility to those whose income is up to 133% of the federal poverty level.This is actually effectively 138% because of a 5% income "disregard". States may opt out of thisexpansion, and many have done so.

Medicare is made more efficient by restructuring the fee-for-service model into a bundled- payment system. Payments will now be made to a hospital and physician group in a single installmentfor a defined period of care rather than many installments to many providers.

The Medicare Part D Coverage Gap will shrink and be eliminated by 2020.

Employers with 50 or more employees will have to offer health insurance to their full-timeemployees or pay a tax penalty if one of these full-time employees has their health care subsidized bythe government.

Establishes several new taxes and fees: Higher Medicare taxes on wealthy individuals, fees oninsurance providers, fees on drug and medical device manufacturers, a 40% excise tax on "Cadillac"insurance plans, and a federal sales tax of 10% on indoor tanning.

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Implications of these Provisions (Some Numbers are Estimates by the CBO):

32 million more Americans will be insured. Five categories of people will remain uninsured:

Illegal immigrants will not be insured under the law

Citizens who choose not to take Medicaid despite being eligible will remain uncoveredPeople who choose not to purchase insurance, instead paying the annual fee, will remainuncovered

People whose coverage would cost more than 8% of their income, and who choose notto purchase insurance, will not pay a fee and will remain uninsured

Those who fall in the coverage gap created by states opting out of the Medicaidexpansion and who do not qualify for subsidized insurance on the exchangeswill remain uninsured.

Health plans will be required to meet certain standards

For most people, premiums are expected to either decrease slightly or stay constant (after subsidies are applied on the exchanges). Furthermore, premiums will become more stable due to newregulations. Any premium increase will likely be due to the fact that some plans will required toincrease their quality to meet new standards.

Individuals falling in the Medicare Part D Coverage Gap will save approximately 40% becausethe law secured a discount from pharmaceutical companies for brand-name drugs.

The deficit will be reduced by a projected $210 billion from 2012-2021. (The "doc fix" not being addressed in the CBO Report is irrelevant, as it would occur regardless of whether the PPACAhad been passed).

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