Just a quick note that the way in which the one-year doc fix is paid for leaves considerable discresion to the HHS Secretary. Here’s how it is characterized at HealthReformGPS:
[I]n cases in which a taxpayer experiences “excess advance payments,” the law provides that the taxpayer must repay the excess in the form of an additional tax payment representing the amount owed for that year. Repayment cannot exceed $400 in the case of individuals with incomes below 400 percent of the federal poverty level. However, amendments to the ACA passed by the Senate on December 8, 2010 as part of the Medicare and Medicaid Extenders Act of 2010 would significantly increase the amount that can be recouped in the case of “advance payments to a taxpayer,” as follows:
- $600 in the case of families with household incomes under 200% FPL;
- $1,000 in the case of families with household incomes between 200%-250% FP
- $1,500 in the case of families with household incomes between 250% and 300% FPL;
- $2,000 in the case of families with household incomes between 300% and 350% FPL;
- $2,500 in the case of families with household incomes between 350% and 400% FPL;
- $3,000 in the case of families with household incomes between 400% and 450% FPL; and
- $3,500 in the case of families with household incomes between 450% and 500% FPL. [Emphasis mine.]
So these are maximum amounts that can be recouped. That doesn’t mean they are the amounts that will be recouped. The Secretary may set lower amounts. This “pay-for” may not actually pay for very much.
