Sec. 202 (p. 91-92)

Each individual is required to enroll in a “qualified plan” (a plan designed by the Secretary of Health and Human Services). If you have your own insurance, as soon as any term in your current plan changes, such as the co-pay, deductible or benefit, you must change to a “qualified plan”.

Sec 224 (p.118)

18 months after the bill becomes law the Secretary of Health and Human Services will decide what a “qualified plan” covers and how much you will be legally required to pay for it. (That’s like a banker telling you to sign the loan agreement now then filling in the interest   rate and repayment terms 18 months later)

The Congressional Budget Office estimates individuals earning   $44,000 who purchases his own insurance will have to pay a    premium of $5,300 and an estimated $2,000 in out of pocket    expenses for a total of $7,300 which is 17% of his pretax income.  A   family earning $102,100 will have to pay a $15,000 premium plus   an estimated $5,300 out of pocket for an annual total of $20,200 or   20% of pretax income.  Individuals and families earning less than   these amounts will be eligible for to be determined subsidies paid   directly to their insurer.

Sec 303 (p.167-168)

Although the “qualified plan” is not yet designed, it will be of the   one size fits all variety.  The benefits will be the same, only the co-  pays and deductibles will vary.  You will have to enroll in the same   plan whether the government is paying for it or you and your   employer are footing the bill.  (This is like when Ford made the Model T, you could order any   color car, as long as it was black.  Consumers were so distressed,   GM became the leading car company because it offered a choice of   colors.)

Sec 596 (p.297-299)

When you file your income taxes, you must include proof you are in a “qualified plan”, otherwise you will be fined thousands of dollars.  Illegal immigrants are exempt.

Sec 412 (p. 272)

Employers with payrolls over $750,000 must provide a “qualified   plan” for their employees and pay 72.5% of the cost for individuals   and a smaller percentage for family coverage or incur an 8% payroll   tax.  Employers with payrolls from $500,000 to $750,000 will be   fined 6%.

Sec 1302 (pp.672-692)

Medicare is changed from a fee for service payment system in which patients choose which doctors to see and doctors are paid for   each service they provide; instead, those on Medicare will go to a   medical home, essentially a version of an HMO with restrictions on   care.

A primary care provider manages access to costly specialists and   diagnostic tests for a flat monthly fee.  The bill specifies that   patients will have to settle for a nurse practitioner rather than a   physician as the primary care provider. 

(The reduction of referrals to specialists will mean less costly and   aggressive treatment given to the elderly with cancer and other   serious diseases)  The life expectancy of seniors will decline.

Sec 1114 (pp.391-393)

Physicians are replaced with physician assistants in overseeing care for hospice patients.

Sec 1158-1160 (pp.499-520)

Creates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country for hospital patients   in higher cost areas such as New York and Florida.

How long do you think doctors will stay in practice under these conditions?

Sec 1161 (pp.520-545)

Payments to Medicare Advantage plans (which are used by 20% of seniors) will be cut.

Sec 399V (p. 1422)

Grants billions of dollars to community “entities” (like ACORN)   with no required qualifications except having “documented    community activity and experiences with community healthcare   workers to “educate, guide and provide experiential learning    opportunities” aimed at drug abuse, poor nutrition, smoking and   obesity.”  Each community health worker program receiving funds   under the grant will provide services in the cultural context most   appropriate for the individual served by the program.”  (But no plans to increase funding to create more family physicians.    If the personal tuition costs of creating a doctor remains the same   and the financial rewards are reduced, so do you think there will be   more or less doctors?)

Sec 222 (p. 617)

Reimbursement is provided for culturally and linguistically appropriate services.  This program will train healthcare workers to inform Medicare beneficiaries of their “right” to have an interpreter at all times with no co-pays for language services.

Sec 2521 (p. 1379)
Sec 2533 (p. 1437) 

Establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary school health science programs.

Sec 305 (p. 189)

Automatic Medicaid enrollment of newborns who do not otherwise have insurance.