Originally Posted by dc_dux

It helps 30+ million uninsured...that is a huge improvement by any reasonable standard.

It helps nearly 200 million currently insured by prohibiting excluding pre-existing conditions and setting limits on out-of-pocket expenses, among other benefits (free preventive care, including such procedures as colonoscopies and mammograms).

The unions are not exempt from the plan.

Nor are members of Congress who will be required to join the Insurance Exchange when it is operational.

It does not cut Medicare...it cuts excessive payments to Medicare Advantage providers.

Cuts to Medicare Advantage: The bill includes a new competitive bidding program that will
cut $120 billion from Medicare Advantage (MA).37 Plans would have to submit bids, and the
benchmark paid to plans would be the average of the local plan bids. The benchmarks currently
range from about 100 percent to more than 150 percent of local per capita spending in the feefor-
service sector. Plans that bid below the benchmark would receive 100 percent of the
difference and must use those funds to reduce cost-sharing or provide other benefits (but could
no longer use rebates to subsidize Part B or D premiums). Plans that bid above the benchmark
would have to charge the difference to their enrollees. The provision also creates performance
bonus payments based on a plan’s level of care coordination and care management and
achievement on quality rankings. According to CBO, this change will result in reduced extra
benefits, like vision care, free flu shots, and dental coverage.38 Average additional benefits
offered by MA plans would drop from $135 to $49 per month in 2019. Enrollment in MA plans
in 2019 is projected to be 2.6 million lower than under current law.
The bill includes language from an amendment offered by Senator Nelson (Florida) to the
Finance Committee bill that grandfathered extra benefits for current MA enrollees in high-cost
areas of the country where average plan bids are at or below 75 percent of local fee-for-service
costs. The provision would apply to certain MA bidding regions, not to states as a whole. The
extra benefits would be reduced by five percent each year beginning in 2013. Additionally, the
HHS Secretary would provide “transitional” benefits in 2012 to MA beneficiaries in some areas
of the country who would otherwise experience a “significant reduction” in extra benefits. A
new provision was added that grants the Secretary the authority to deny MA plan bids if the bid
proposes a “significant” increase in cost-sharing or decrease in benefits. The bill includes new
bonus payments for coordination of care programs.


H.R.3590: Patient Protection and Affordable Care Act - U.S. Congress - OpenCongress



But, you're correct...it is not universal and it does not happen immediately.