What You Should Know About the Democrat Health Bill – Hidden Taxes, Fines and Bribes

President Obama and his legion, Pelosi, Reid, Stupak, et al, have said basically that once the American people get to know what’s in the healthcare legislation, they’ll actually like it. We all know how very important it is to the President and Speaker Pelosi that the American people be happy.

One must assume, based on the President’s assurance, that once we get to know this health care reform legislation up-close and personally, we’ll be so happy that we’ll all gather on a hilltop and hold hands to sing a groovy song and will vote unanimously to usher in a new age of Aquarius.
Okay. Let’s see if that works.

Here are a couple of things I learned about this legislation since its passage that I had not known previously.

• When you buy your federally mandated, IRS enforced – either by penalty of a fine or imprisonment – health care insurance you may be buying from an insurance company that will donate a portion of what you spend for your insurance to a special fund to help pay for abortions. It is now mandatory that certain insurance carriers provide a portion of what you pay them for health care coverage to a special abortion fund – Stupak’s hastily scribbled hall pass aside, this is now law.
          o There is no special fund for Breast Cancer
          o There is no special fund for Heart Disease
          o There is no special fund for Diabetes or MS
          o There is ONLY a special fund to pay for abortions

• When you sell a home in Mr. Obama’s new and improved America a 4% tax will be levied on your proceeds from the sale which will go to cover Health Care costs.

• Tanning? Apparently Dems want us all to be pasty for some reason…if you frequent tanning salons, you will pay a 10% excise tax.

• Mobility be damned! If you purchase a wheelchair, you will pay a 2.3% excise tax. I’m sure those confined to wheelchairs will consider this to be a great step forward in care.

• Pharmaceutical companies will be allowed to pass a $3 billion annual fee on to you, the consumer, in the form of more expensive drugs and medication.

• About those fines – Citizens who don’t purchase insurance would be subject to a fine of $325 in 2015 and $695 in 2016. Individuals may be subject to a charge equal to as much as 2.5 percent of their income in 2016.

• The Medicare payroll tax will now be applied to investment income, beginning in 2013.
          o A new 3.8 percent tax will be levied on interest, dividends,    capital gains and other investment income for individuals making more than $200,000 a year and couples making more than $250,000.

• The Medicare payroll tax will increase by 0.9 percentage point to 2.35 percent on wages above $200,000 for individuals and $250,000 for married couples filing jointly.

• A 40% tax on health benefits happens in 2018 and applies to premiums exceeding $10,200 a year for individuals and $27,500 for families. In other words, that phrase – “If you like your current insurance, it won’t change” was a big fat lie. If you have great insurance, you’ll now be taxed for the privilege. A 40% tax is a change.

• Taxes and more taxes –
          o According to the Joint Committee on Taxation, a nonpartisan agency, this legislation will generate $409.2 billion in additional taxes by 2019. The Congressional Budget Office also says that the Health Care Reform legislation will impose about $69 billion in penalties for both individual and businesses who don’t meet new mandates to buy health insurance.

• Here’s a really sneaky tax “increase” – if you itemize your tax returns, the deductible for medical expenses will change. You will only be allowed to deduct medical expenses in excess of 10% of your adjusted gross income. Currently that number is 7.5%.

• A medical plan tax that includes several different provisions to increase multiple taxes on things such as cosmetic surgery, cafeteria plans, health insurance providers, production and importation of drugs and medical devices, medical information providing, hospitals and the adjusted gross income floor of medical expenses.

• Doctors and hospitals will receive less compensation than they do now to control revenue streams.

• The Medicare program will see $500 billion in cuts to its program along with the Medicare tax being raised.

• 60% of new enrollees in health care programs will be fully subsidized by you.
Then there’s all those “incentives” laced into the legislation – strangely – only for those Representatives who voted “Yes” for this legislation.

• $300 Million more in Medicare subsidies for Louisiana

• NV, MT, WY, ND, UT all receive $2 billion in Medicare subsides

• Connecticut gets $100 Million to build a hospital

• 11 states total receive 8.5 Billion in Medicaid payments

Even the most casual observer must wonder how a struggling economy, with out-of-control unemployment can bear the burden of so much additional taxation and spending.

President Obama gloated, “This is what change looks like.”

To be fair, I suppose it is possible that Barack Obama never actually said the change he was promising would be positive change, or even change that the American people wanted.

This may be what change looks like, but it is also what bitter partisanship looks like.
Obama promised to reach across the aisle. He never mentioned that once he reached across he was going to sucker punch the Republicans.

Never did I hear Obama promise to ignore the will of the people.

Since last night, Obama, Pelosi and their legion have taken time to grin and pose for the cameras and proclaim the passage of this bill as “historic”. They’ve taken time to pat themselves on the back and to say that this legislation compares to the passage of Medicare, the passage of Social Security and the passage of Civil Rights.

In terms of the monumental impact this law will have on our nation, they are correct to rank it up there with all of those past life-changing pieces of legislation. There is however one incredibly glaring difference. Those milestone pieces of legislation all passed with bi-partisan support.

The only bi-partisanship exhibited in the passing of this legislation was on the side of dissent with more than 30 Democrats crossing over to the Republican side of the aisle to cast their “No” votes.  The only Democratic Representative from the state of Texas to vote “No” was Waco’s Chet Edwards.

Obama, Pelosi and the others have suddenly become aware of the words “prayer” and “constitution” and the terms “founding fathers” and to watch them use these words to justify their power grab is insulting. It’s every bit as insulting as the American people being told over and over again that “once you understand it” you’ll be happy to have it.

The condescending attitude from this President and this Congress is unprecedented.  The President added to the insult by saying, “We proved that this government — a government of the people and by the people — still works for the people.”

Mr. President that is perhaps your boldest and most condescending lie to date.
56% of the people in this nation opposed this health care reform legislation. Your actions have proven that your words have no meaning and that your government — a government of the politician and for the politician — views the people with absolute disdain.

John G. Winder , The Cypress Times 

Timeline of Major Provisions in the Democrats’ Health Care Package

Source:  Committee on Ways and Means Republicans

2009

•2‐year tax credit (total cap of $1B) for new chronic disease therapy investments
•Medicare cuts to hospitals begin (long‐term care (7/1/09) and inpatient and rehabilitation facilities (FY10))

2010

•States and Federal officials review premium increases
•FDA authorized to approve “follow‐on” biologics
•Increase brand name pharmaceutical Medicaid rebate (from 15.1% to 23.1%)
•Medicare payments to physicians in primarily rural areas increase (2 years)
•Deny “black liquor” eligibility for cellulosic biofuel producers credit
•Tax credits provided to certain small employers for health care‐related expenses
•Increase adoption tax incentives for 2 years
•Codify economic substance doctrine and impose penalties for underpayments (transactions on/after 3/23/10)
•Provide income exclusion for specified Indian tribe health benefits provided after 3/23/10
•Temporary high‐risk pool and high‐cost union retiree reinsurance ($5 B each for 3.5 years) (6/23/10)
•Impose 10% tax on indoor UV tanning (7/1/10)
•Medicare cuts to inpatient psych hospitals (7/1/10)
•Prohibits lifetime and annual benefit spending limits (plan years beginning 9/23/10)
•Prohibits non‐group plans from canceling coverage (rescissions) (plan years beginning 9/23/10)
•Requires plans to cover, at no charge, most preventive care (plan years beginning 9/23/10)
•Allows dependents to stay on parents’ policies through age 26 (plan years beginning 9/23/10)
•Provides limited protections to children with pre‐existing conditions (plan years beginning 9/23/10)
•Hospitals in “Frontier States” (ND, MT, WY, SD, UT ) receive higher Medicare payments (FY11)
•Hospitals in “low‐cost” areas receive higher Medicare payments for 2 yrs ($400 million, FY11)

2011

•Medicare Advantage cuts begin
•No longer allowed to use FSA, HSA, HRA, Archer MSA distributions for over‐the-counter medicines
•Medicare cuts to home health begin
•Wealthier seniors ($85k/$170k) begin paying higher Part D premiums (not indexed for inflation in Parts B/D)
•Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT scans, etc.
•Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable medical equipment
•Impose new annual tax on brand name pharmaceutical companies
•Americans begin paying premiums for federal long‐term care insurance (CLASS Act)
•Health plans required to spend a minimum of 80% of premiums on medical claims
•Physicians in “Frontier States” (ND, MT, WY, SD, UT ) receive higher Medicare payments
•Prohibition on Medicare payments to new physician‐owned hospitals
•Penalties for non‐qualified HSA and Archer MSA distributions double (to 20%)
•Seniors prohibited from purchasing power wheelchairs unless they first rent for 13 months
•Brand name drug companies begin providing 50% discount in the Part D “donut hole”
•10% Medicare bonus payment for primary care and general surgery (5 years)
•Employers required to report value of health benefits on W‐2
•Steps towards health insurance administrative simplification (reduced paperwork, etc) begins (5 yr process)
•Additional funding for community health centers (5 years)
•Seniors who hit Part D “donut hole “in 2010 receive $250 check (3/15/11)
•New Medicare cuts to long‐term care hospitals begin (7/1/11)
•Additional Medicare cuts to hospitals and cuts to nursing homes and inpatient rehab facilities begin (FY12)
•New tax on all private health insurance policies to pay for comp. eff. research (plan years beginning FY12)

2012

•Medicare cuts to dialysis treatment begins
•Require information reporting on payments to corporations
•Medicare to reduce spending by using an HMO‐like coordinated care model (Accountable Care Organizations)
•Medicare Advantage plans with a 4 or 5 star rating receive a quality bonus payment
•New Medicare cuts to inpatient psych hospitals (7/1/12)
•Hospital pay‐for‐quality program begins (FY13)
•Medicare cuts to hospitals with high readmission rates begin (FY13)
•Medicare cuts to hospice begin (FY13)

2013

•Impose $2,500 annual cap on FSA contributions (indexed to CPI)
•Increase Medicare wage tax by 0.9% and impose a new 3.8% tax on unearned, nonactive business income for those earning over $200k/$250k (not indexed to inflation)
•Generally increases (7.5% to 10%) threshold at which medical expenses, as a % of income, can be deductible
•Eliminate deduction for Part D retiree drug subsidy employers receive
•Impose 2.3% excise tax on medical devices
•Medicare cuts to hospitals who treat low‐income seniors begin
•Post‐acute pay for quality reporting begins
•CO‐OP Program: Secretary awards loans and grants for establishing nonprofit health insurers
•$500,000 deduction cap on compensation paid to insurance company employees and officers
•Part D “donut hole” reduction begins, reaching a 25% reduction by 2020

2014

•Individuals without gov’t‐approved coverage are subject to a tax of the greater of $695 or 2.5% of income
•Employers who fail to offer “affordable” coverage would pay a $3,000 penalty for every employee that receives a subsidy through the Exchange
•Employers who do not offer insurance must pay a tax penalty of $2,000 for every fulltime employee
•More Medicare cuts to home health begin
•States must have established Exchanges
•Employers with more than 200 employees can auto‐enroll employees in health coverage, with opt‐out
•All non‐grandfathered and Exchange health plans required to meet federally mandated levels of coverage
•States must cover parents /childless adults up to 138% of poverty on Medicaid, receive increased FMAP
•Tax credits available for Exchange‐based coverage, amount varies by income up to 400% of poverty
•Insurers cannot impose any coverage restrictions on pre‐existing conditions (guaranteed issue/renewability)
•Modified community rating: individual or family coverage; geography; 3:1 ratio for age; 1.5 :1 for smoking
•Insurers must offer coverage to anyone wanting a policy and every policy has to be renewed
•Limits out‐of‐pocket cost‐sharing (tied to limits in HSAs, currently $5,950/$11,900 indexed to COLA)
•Insurance plans must include government‐defined “essential benefits ” and coverage levels
•OPM must offer at least two multi‐state plans in every state
•Employers can offer some employees free choice vouchers for health insurance in the Exchange
•Government board (IPAB) begins submitting proposals to cut Medicare
•Impose tax on nearly all private health insurance plans
•Medicare payment cuts for hospital‐acquired infections begin (FY15)

2015

•More Medicare cuts to home health begin

2016

•States can form interstate insurance compacts if the coverage with HHS approval (2016)

2017

•Physician pay‐for‐quality program begins for all physicians
•States may allow large employers and multi‐employer health plans to purchase coverage in the Exchange.
•States may apply to the Secretary for a limited waiver from certain federal requirements

2018

•Impose “Cadillac tax on “high cost” plans, 40% tax on the benefit value above a certain threshold: ($10,200 individual coverage, $27,500 family or self‐only union multiemployer coverage)

The Key To Socialism In The USA: Destroy The Tea Party Movement

From Dr. Melissa Clouthier:

Why stop at socialism? I mean, really. That’s just a pretty way of saying communism. Here’s the most accurate label for the New Left:  NeoComms. I plan to use it everywhere.

Think I’m being extremist? Well David Frum and all his smooth talking moderate talkers can chew on this:

These debates are happening on the basis of charges like reformism, revisionism, and right opportunism. For me, this is proof that not enough has been done to modernize our organization and to transform Marxism from an old catechism into a real guide to action and a way of understanding the concrete conditions of struggle in our own country and in our own time. As one of the main preconvention documents said, “We have to accept and adapt to the reality that times have changed” (from U.S. Politics at a Transition Point).

The growing influence of the Tea Party movement, the long and grueling fight that was healthcare reform, and so many other features of the current struggle should demonstrate convincingly that though the 2008 election dealt a major blow to the ultra-right, it did not knock them out completely as we had hoped.

Rather than jumping to the conclusion that we need to shift our focus to criticism of Obama, the Democratic Party, or the labor movement, we should instead be seeking to recommit ourselves to defeating the ultra-right and building the broad democratic coalition more strongly than ever. This is the orientation that the main discussion documents point us toward. We have to keep in mind who the “main social force(s) hindering progressive development” are and keep our fire aimed at them (from U.S. Politics at a Transition Point).

If the policy of defeating the ultra-right was correct in the 1980s, the 1990s, and 2008, how can it not be just as correct now that we are in a moment of transition toward a time when we can more forcefully go on the offensive? Let’s update our strategic policy to take account of post-election developments of course, but let’s not take a path that would isolate us from the rest of the coalition for change.

So the threat to Marxism-Leninism isn’t from President Obama and the Democrats. Indeed, the problem with the Democrats is their implementation. The communists merely disagree with how it’s happening. They like that it’s happening.

And in fact, the real problem is the Tea Partiers. The pesky folks pushing back against socialism must be stopped. Notice that they didn’t mention the Republicans.

The article ends with a plea to change the communist movement, maybe even renaming it and making it more palatable to the modern world.

Why? Why hide what you are? Ultimately, don’t bother. Just call yourselves Democrats and be done with it. And commies should worry about Tea Partiers. They name you. And the Democrats, too.

Communists. Socialists. Statists. Totalitarians.

NeoComms.

The name change won’t disguise a NeoComm. The ideas reveal the heart of these people.

Much as they’d like to destroy the Tea Party movement, it won’t happen. The Tea Party movement is organic. It will morph and change and grow. It isn’t headed by an organization. It doesn’t require one leader to exist.

But most of all, the beliefs of the Tea Party folks will help them win in the end. Liberty. Ingenuity. Creativity. Life. Happiness. Freedom. Those values beat the smallness of socialism. Always.

Why Socialism Doesn’t Work – A Class Experiment

An economics professor at a local college made a statement that he had never failed a single student before, but had once failed an entire class. That class had insisted that Obama’s socialism worked and that no one would be poor and no one would be rich, a great equalizer.

The professor then said, “OK, we will have an experiment in this class on Obama’s plan”.

All grades would be averaged and everyone would receive the same grade so no one would fail and no one would receive an A.

After the first test, the grades were averaged and everyone got a B. The students who studied hard were upset and the students who studied little were happy. As the second test rolled around, the students who studied little had studied even less and the ones who studied hard decided they wanted a free ride too so they studied little.

The second test average was a D! No one was happy.

When the 3rd test rolled around, the average was an F.

As the tests proceeded, the scores never increased as bickering, blame and name-calling all resulted in hard feelings and no one would study for the benefit of anyone else.

All failed, to their great surprise, and the professor told them that socialism would also ultimately fail because when the reward is great, the effort to succeed is great but when government takes all the reward away, no one will try or want to succeed.

Could not be any simpler than that.

Without the Consent of the Governed

WITHOUT THE CONSENT OF THE GOVERNED
By JB Williams Friday, March 26, 2010

Obama’s Unconstitutional Health Care Treachery is just the beginning of a dark and sinister age in American history. Now that Obama & Co. have found the legislative mechanisms to subvert the Law of the Land on the federal health care grab, they intend to rush forward with the passage of “financial reform”—“energy reform”—and “Immigration reform”—none of which are any type of “reform.”

All of these measures are massive federal power and resource grabs, moving the vast resources of the United States from private sector control to public sector control. It is called socialism, by way of democratic process.

All of it will be done over the next few months without the consent of the governed, before the November election when leftists expect to lose their fifteen minutes of power in the voting booth. They plan to advance their anti-American agenda no matter how many stand opposed, and in such a manner that it can never be reversed.

As I pointed out very clearly in my most recent column, for any federal law to be “constitutional,” it must meet this minimum standard…

1. It must be within the limited federal powers enumerated in the Constitution
2. It must enjoy the support of the vast majority of “the governed,” from which all federal powers are derived
3. It must not infringe upon the unalienable individual rights of any citizen
4. It must not infringe upon the rights of any state, protected by the Tenth Amendment
5. It must become law by way of legal legitimate legislative process

Obama’s Health Care treachery violates all five of these standards and as a result, it cannot be allowed to stand. They are just getting started. This is about much more than health care, yet health care is where the people must put a stop to all of it.

How the rest of the world runs is of no consequence to Americans. In the United States of America, “the people” are the government, and our federal government derives every ounce of its power strictly from the “consent of the governed.” Our elected officials are not Kings – they are “servants.”

Read More…

Max Baucus Admits To Being A Communist

Well, maybe not exactly in those words, but he said this:

In an unusual speech on the Senate floor moments ago, Max Baucus declares that the “healthcare bill” to be “an income shift, it is a shift, a leveling to help lower income middle income Americans.” Baucus continued, “[t]oo often, much of late, the last couple three years the mal-distribution of income in America is gone up way too much, the wealthy are getting way, way too wealthy, and the middle income class is left behind. Wages have not kept up with increased income of the highest income in America. This legislation will have the effect of addressing that mal-distribution of income in America.”

That is exactly what Communists believe, so Max Baucus is clearly a secret Communist. I suspect most “progressive” Democrats agree with him.

Max Baucus is the Chair of the Senate Finance Committee, and the Democrat most responsible fo Obamacare’s final shape other than Nancy Pelosi.

Baucus’ candor is appreciated, though the fact that he waited until the bill passed to announce the real agenda behind the massive tax hikes isn’t a profile in courage. And the seniors on fixed income who are about to lose Medicare Advantage would laugh at Baucus’ pseudo-populism. (h/t Hugh Hewitt)

You can see the video below.

We all knew that the Obamacare bill wasn’t about healthcare. There were many ways to achieve healthcare reform that would have cost a fraction of the cost of the Obamacare bill. There had to be more to it. Sen. Baucus has admitted that there was and defined it as a massive redistribution of wealth in America.

The Democrat Party will be remembered as the party responsible for destroying the capitalist system, along with freedom, in America. Now only they can determine how much you have the right to earn. And only they have the right to determine how much you have to give up from your capital to give to those who weren’t as successful as you.

The Statue of Liberty is shedding tears. When asked by a citizen, “What have you made?”, after coming out of the Constitutional Convention, Benjamin Franklin retorted, “A Republic, if you can keep it.” Sadly, it doesn’t appear that we can.

We cannot let the statists and the Marxists continue to run this country. America was founded as the Land of the Free, where citizens can be free to live their lives with minimal interference from their government. We must take it back. We have to see that conservative Republicans are elected in November so we can take back the House of Representatives

20 Ways ObamaCare Will Take Away Our Freedoms

20 Ways ObamaCare Will Take Away Our Freedoms
By:  David Hogberg

With House Democrats poised to pass the Senate health care bill with some reconciliation changes later today, it is worthwhile to take a comprehensive look at the freedoms we will lose.

Of course, the overhaul is supposed to provide us with security. But it will result in skyrocketing insurance costs and physicians leaving the field in droves, making it harder to afford and find medical care. We may be about to live Benjamin Franklin’s adage, “People willing to trade their freedom for temporary security deserve neither and will lose both.”

The sections described below are taken from HR 3590 as agreed to by the Senate and from the reconciliation bill as displayed by the Rules Committee.

1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)

2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).

3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).

4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).

5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough. (Section 2714).

6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.

You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).

7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d) (1) (A))

8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).

9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).

10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).

11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))

12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A))

13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).

14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)

15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).

16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).

The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).

17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)

18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).

19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).

That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).

20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).