Still don't know what's in the Affordable Health Care Bill?

In recent days (and almost every month since it passed) we've heard numerous reports that Americans still don't understand the health care bill—as if the massive disinformation campaign by opponents of the bill was oh-so-effective even a year later. But digging around some of the polls on health care from recent years, another picture emerges. It isn't just that Americans don't understand the new bill or that they didn't understand it before it passed—largely, they didn't. A high percentage of Americans don't understand key aspects of the U.S. healthcare system (that Medicare is a single-payer system, what FSAs are good for) at all. Polls have indicated that 25% Americans don't know what they pay for their health care. The Obama administration faced an uphill battle on explaining health care and it's still got a long way to go.

1. First of all, what's it called? We're talking about the Affordable Care Act,  H.R. 3962.
2. The bill, contrary to a widely held belief, did not raise taxes on most Americans this year. 
3. Cost: $940 billion over ten years. The CBO estimates it will reduce the government's deficit over time.
4. It's a long bill, but not really that long. It contains roughly 234,812 substantive words, about the same as a long Harry Potter book, less than twice as many words as the Energy Bill of 2007, and twice the size of the Medicare Rx bill of 2033. 

When asked individually about many of the provisions of the Affordable Care Act, most Americans like the components, but many don't realize any of them are in the bill. The guiding principal of the bill is that fewer uninsured Americans means lower costs across the health care system. It's a bill that includes mandates on states and individuals as well as extensive consumer protections. As a former U.S. House of Representatives intern, it brings me pleasure and a touch of nostalgia to break down H.R. 3962 as much as I can for those that haven't got the gist of it.

1. All Americans who can afford it will be required to purchase health care by 2014. States will be required to create health insurance exchanges.

2. Insurance companies can no longer cap coverage. Higher premiums for women are banned. 

3. Insurance companies cannot refuse coverage for pre-existing conditions. This goes fully into effect in 2014. Right now, under the new law, children can't be turned down for pre-existing conditions.

4. Dependent children up to 26 can remain on their parent's policy.

5. Employers with more than 50 employees have to provide coverage in 2014. Smaller employers get a tax credit if they do.

6. Preventative care, like physicals, is now free under insurance—that means not subject to co-pays or out of pocket payments.

7. Seniors on Medicare will get help for drug expenditures—filling in the donut hole on spending between $2700 and $6154. Medicaid is expanded to cover poor families and childless adults.

8. The plan is paid for by fees on drug companies, insurers, taxes on overly generous health plans, the sale of medical devices, and fees for employers who don't offer coverage and people who refuse coverage. Also, it includes a tax on tanning salons. The Medicare payroll tax will be applied to investment income and increase for those making more than $200,000, or married couples making more than $250,000.