By Tom Curry National affairs writer
msnbc.com
updated 12/18/2009 11:37:57 AM ET 2009-12-18T16:37:57

Claim: The health care reform bill's subsidies are a boon for upper-middle income people.

In the first 10 years after enactment, the Senate bill would spend more than $600 billion on subsidies to help people who were not already in an employer-sponsored plan to buy coverage from insurance marketplaces, or exchanges. According to an estimate by Richard Foster, the chief actuary of the Medicare program, about 28 million people would receive subsidies. The bill sets a uniform eligibility level for all 50 states, without regard to income differences between wealthier and poorer states. Subsidies would go to those with incomes up to 400 percent of the federal poverty level, or about $88,000 for a family of four. People with incomes less than 133 percent of the federal poverty level, or about $29,300 for a family of four, would not get subsidies, but instead would be covered by the Medicaid program.

Fact or fiction?
Fact. Setting eligibility at a uniform standard of 400 percent of the federal poverty level means that in most states, upper-middle income people will be eligible for subsidies. In 43 states, the median income for a family of four is below 400 percent of the poverty line. In many states, the median income is well below that level: in Missouri, for instance, median income for a family of four was about $71,000 in 2008, in Tennessee, it was about $64,200. However, other parts of the bill would likely increase taxes on middle-class people and shift costs to them. For example, the Senate bill imposes a tax on high-premium insurance plans. The Mercer consulting firm said nearly two-thirds of the employers it surveyed would cut health benefits to avoid paying the tax; about a fourth would pass along the cost of the tax to their employees.

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