Deciphering Healthcare Reform

You hear about it night after night: Health care reform, sweeping changes, protests, and now, the big vote in the United States Senate Finance Committee Tuesday, sending the $829 billion plan to the Senate for floor the first time.

Still, most don't know much about what it all means or how it will change their lives.

It's not that we're all too stupid to "get it". This is complicated. But when you go past the headlines and get into the teeth of the plan, you start to figure out it's going to mean something to just about everyone.


"It would be the biggest change in our health care system since 1964 when medicare passed," said Webster University business professor, Jim Brasfield.

Brasfield agreed to help Fox 2 sift through the health care muck, Tuesday.

The plan would extend coverage to close to 30 million now uninsured; prohibit insurers from denying coverage for pre-existing conditions, cap the out-of-pocket expenses you have to pay, and require everyone to have health insurance or face fines of up to $750.

For a family of 4, with no insurance and a $50,000 yearly income, coverage would cost about $13,000, Brasfield said. The government would pay about $8900 of it, with the family responsible for about $4100.

They'd buy coverage through a government-based health care exchange.

"Kind of like a giant Ebay for selling insurance," Brasfield said. "Insurance companies would participate. It would be on websites. There would be consultants or advisors to people and they would say, 'here, you're eligible for so much subsidy because of your income."

He said the millions of uninsured who be required to buy coverage, would help cover the plan's enormous cost.

"You're going to have .. 20 - 30 million more people contributing into the system," Brasfield said. "That's going to be a lot more money on the table to pay those additional costs."

He said if you currently are in an employer provided plan, that shouldn't change; the new plan encourages employers to continue offering coverage: large employers with 50 or more workers would have to pay fees if they don't. Small businesses owners with fewer workers would get tax credits if they do. Overall, there should be more new money coming in than going out.

"97% of the cost in a given year is generated by 50% of the population. So half the population generates 97% of the cost. The other half of the population generates only 3% of the cost," Brasfield said.

Still, he said that overall cost is so large, the plan requires about $400 billion dollars in medicare cuts. There would also be a tax insurance companies would have to pay on the high end plans they offer, so-called "Cadillac" plans.

The influx of new customers would dwarf what they pay in new taxes. But when you get past the headlines and into the teeth of the plan, you start to figure out it's going to mean something to you, no matter who you are.