NCPA - National Center for Policy Analysis


March 24, 2010

While the health care bill is not as sweeping as many had once hoped (or others had feared), make no mistake:  The new legislation will dramatically change the nation's health care system.

So who wins and who loses?  "The people who gain the most are low-income people who do not get health insurance from an employer," says John Goodman, president, CEO and the Kellye Wright Fellow of the National Center for Policy Analysis.  "Just about everybody else loses."

Groups that will especially bear the burden include:

  • Generation Y: Most of the 19 million uninsured Americans between the ages of 18 and 34 will be forced to buy coverage -- coverage likely more expensive than they might have otherwise chosen.
  • Anyone who earns more than $200,000: Workers earning more than $200,000 a year or couples with a combined income over $250,000 will pay an additional 0.9 percent in federal income tax to help fund Medicaid expansion starting in 2013, and will likely pay a new 3.8 percent Medicare tax on all investment income.
  • Individuals with so-called Cadillac health insurance: A 40 percent tax will be levied on plans with premiums of $10,200 or more per person.

Goodman also notes that "as many as 8.5 million seniors could lose their Medicare Advantage coverage altogether" under government plans to reduce benefits offered under the program.

Advocates of the legislation argue that winners include anyone with a preexisting condition, recent college graduates who can now get coverage through their parents, small businesses who will have access to insurance pools and doctors who will get paid for seeing uninsured patients they were treating for free. 

In addition, individuals aged 60 to 64 - the oldest age demographic not eligible for Medicare - will pay no more than three times the cost of the premium paid by a healthy 20-something.  But as Goodman notes, "People who are 60 to 64 are going to pay lower premiums than they otherwise would because people who are 20 to 24 are going to pay higher premiums."

Source:  Catherine Holahan, "Health Care Reform: Who Wins and Who Loses," CBS MoneyWatch, March 22, 2010.

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