Patient Protection and Affordable Care Act (H.R. 3590)

On March 23, 210 President Obama signed into law sweeping and historical health care reform legislation, H.R. 3590, the Patient Protection and Affordable Care Act. Lawmakers are debating H.R. 4872, the Health Care and Education Reconciliation Act of 2010, a reconciliation bill that would amend H.R. 3590. The House passed H.R. 4872 on March 21, 2010 and the Senate must take up the measure.

H.R. 3590 as a stand alone measure provides the following:

• For group health plans and individual health insurance coverage: prohibition from establishing unreasonable annual limits or lifetime limits; restricts rescissions; requires minimum coverage for preventive health services; continues dependent coverage until age 26.
• Creates exchanges for purchasing health insurance coverage.
  Establishes a refundable tax credit to provide premium assistance for coverage under a qualified health plan.
• Provides businesses with a tax credit for the premium cost of health insurance coverage.
• Requires individuals to maintain minimum essential coverage or be subject to a penalty.
• Requires automatic enrollment for employees of large employers.
• Imposes a 40% excise tax on health coverage above certain dollar amounts.
• Raises the HI tax on wages and self-employment income in excess of $200,000 ($250,000 for joint filers) by 0.9%.
• Imposes annual fees on manufacturers and importers of branded drugs, manufacturers and importers of certain medical devices, and health insurance providers.
• Raises the Adjusted Gross Income ("AGI") floor for deducting medical expenses from 7.5% to 10% (7.5% remains in effect for individuals over 65 and their spouses through 2016).
• Implements a $500,000 deduction limitation on taxable year remuneration to officers, employees, directors, and service providers of covered health insurance providers.
• Requires employer W-2 reporting of the value of health benefits.
• Increases the penalty for nonqualified health savings account distributions from 10% to 20%.
• Limits health flexible spending arrangements in cafeteria plans to $2,500 (indexed for inflation after 2011).
• Requires information reporting on payments to corporations.
• Imposes additional requirements for Sec. 501(c)(3) hospitals.
• Conforms the definition of medical expenses for HSAs, Archer MSAs, health FSAs, and HRAs to the definition of the itemized deduction for medical expenses (excludes over-the-counter medications, except if prescribed by a physician).
• Imposes a 10% excise tax on indoor tanning services.
• Makes the adoption credit refundable; increases the qualifying expense threshold; and extends the credit through 2011.

Meanwhile 13 state attorneys general have filed a lawsuit challenging the constitutionality of the Act. A copy of the complaint is here. It appears the judicial branch will get a chance to weigh in on this legislation.

Estate Planning is a Loving Act

There is no question that estate planning understandably takes an emotional toll on clients. In addition to facing the emotionally charged issues associated with handling money, clients must face their own mortality. Clients may also have to come to grips with strained family relationships, and address how best to provide for the future well being of children or other loved ones. Often, clients "gag and choke" with the gut-wrenching choices that surround the estate planning process. Fear of planning often leads to the paralysis of analysis.

A Loving Act

We believe that estate planning can be a proactive, positive influence. Planning for loved ones is a loving act. It really boils down to "Do you want to determine where your money goes; or, do you want the government (in its infinite wisdom) to do that for you?" We handled an estate of a woman who wrote a will and left everything to her two brothers and sister. Unfortunately, all of her siblings predeceased her without leaving any surviving descendants. When she passed away, she left a sizable estate to unknown cousins who lived in eastern Europe with whom she had very little, if any, contact. These sorts of scenarios do not have to happen. However, statistics tell us that 7 out of 10 Americans will never get around to making an estate plan before they die.

Our Approach

We strive to make your estate planning a life affirming experience. We believe that when a client shares his or her hopes, dreams and goals with us, we can create a plan that will design a legacy which reflects the client's values for years to come. When clients capture the vision of creating something that will survive them, it can actually be "fun"!

A number of years ago a married couple with no children came to me to plan their estate. They were in a serious quandary as to what to do with their wealth. We discussed the idea of establishing a plan that would reflect the values that they supported. They ended up leaving their estate to a series of charitable institutions. One of those institutions was the Ronald McDonald House. I suggested that they allow me to initially contact the various charities on an anonymous basis to let them know that they had been named as a beneficiary. At first, the couple was reluctant. However, after considering our advice , they allowed me to put them in touch with the various charitable entities. The staff at the Ronald McDonald House invited our clients to spend a day touring their facility and visiting with families staying at the house. Not long thereafter the wife passed away. Her husband contacted me after her death to thank me. He told me that the one of the best days of their life together was the day they spent touring the Ronald McDonald House. He was so appreciative that we had helped them to create an enduring legacy for them with their estate plan. The husband has since passed away and now a number of charities have substantially benefited from this couple's estate plan.

An Alternative Approach

We do not profess to have all the answers and solutions. Sometimes bringing in other professionals can help families dealing with some of the emotional problems. We can work with licensed marriage and family therapists who can provide additional family services to assist in dealing with family issues in a legacy context. Often, coming up with a family financial philosophy, something akin to a Family Mission Statement, can create a guide for the making of estate planning suggestions.