Health Care Not So Simple #5 Sec 1501 to 1561

In an effort to understand the Affordable Care Act, five furlough mornings have been spent reading the contentious legislation currently causing U.S. government offices to be shuttered.

My assessment so far, is the law makes the consumer its primary focus as well as trying to create financial stability for families. The legislation does impose more regulation and responsibility on the healthcare industry and for employers.

The prickly question that remains unanswered so far is; What are the healthcare plans spending 26-30% of my healthcare premium on to administer a payment on my healthcare bill. Read below for understanding.


Sec 1501

An interesting tidbit thrown in here that has not been mentioned through the media at large - Half of all bankruptcies nationwide are caused by medical medical expenses. The underlying idea is that strengthening coverages for families strengthens their financial security.

Health Plan administrative costs in 2006 were 26-30% of the premiums in small group markets. (Anecdotally, this reminds me of being a private owner of a small restaurant. I paid 22% over the invoice cost for food purchases where the large restaurant purchasers paid 6%. As consumers we are doing the same, paying higher premium for  participating in smaller buying groups).

Individuals not purchasing health insurance will pay a tax in their yearly tax filing. In 2014 it will be $95 and the penalty will increase in future years.

It exempts prior health care sharing ministries (religious exemptions) in existence since 1999.

Sec 1513-1515

This section discusses employer sizes, who has to be covered, notifications and reporting requirements that have to be made. There are potential penalties and tax credits based on the size of the employers business, the number of employees and how long employees have to wait for their insurance coverage to start.

Sec 1553 -1561

Discrimination is prohibited against any healthcare entity or provider who will not provide assisted suicides, euthanasia, or mercy killings.

No regulation shall impede healthcare accessibility.

Any employer providing health insurance for it's employees does not have to participate in the Healthcare Exchange.

No employee may be discharged based on their use of the healthcare exchange or for reporting a violation.


In summary, Sections 1501 through 1561, support the individual, regulate the healthcare plans and the employers. It's definitely a contentious bit of legislation as it probably when the Americans with Disability Act and the Family Medical Leave Act and Social Security were implemented. I'd like to look down the road 20-30 years from now and see it's contribution to our society and if the melodrama of this is as bad as the news makes it out to be. I'll be reading on. Peace to you.

Diane