'Okay, explained like you're a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:
What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.
Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.
So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):
Already in effect:
It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) Newer drugs, less rigorous testing = more class action lawsuits and higher drug costs.
It increases the rebates on drugs people get through Medicare (so drugs cost less)How does something like this work? Who gets the discount, who suffers from or pays for the discount? Drugs cost $200, you get a $50 rebate through medicare, does the drug manufacture give the rebate, the pharmacy, medicare? Can't get a rebate unless there was more profit to begin with.
It establishes a non-profit group, that the government doesn't directly control,  PCORI, to study different kinds of treatments to see what works better and is the best use of money. (  Citation: Page 665, sec. 1181 )Who funds the "non-profit group"? My guess will be the government (read tax dollars)because most non-profit groups who are privately established receive some type of government funds to function. If the gov is going to establish one you know we are going to fund it.
It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. (  Citation: Page 499, sec. 4205 )Good Call.
It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them. So here is a bill to establish the same health care for everyone. But because i have health condition that may limit my ability to hold a job i'll have to pay more than others for the same health care?
It renews some old policies, and calls for the appointment of various positions. WTF does this mean?
It creates a new 10% tax on indoor tanning booths. (  Citation: Page 923, sec. 5000B )So, indoor tanning will cost 10% more now. People figure out that the sun is free and thousands of tanning salons are out of business and tens of thousands are out of work. Even though the free SUN tanning comes with the same or more health risk than indoor tanning.
It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. (  Citation: Page 14, sec. 2711 ) While i agree that by signing on and giving the insurance company what they wanted to insure me they should insure me no matter what because that was the deal; I'm amazed that people haven't figured out how insurance companies work. If everyone has claims for more than they paid in they have no more money for you.
Kids can continue to be covered by their parents' health insurance until they're 26. Makes no difference because they will just raise the rate. They can be on there but as a parent you won't want those bitches on there.
No more "pre-existing conditions" for kids under the age of 19.
Insurers have less ability to change the amount customers have to pay for their plans. How does this work without regulating how much profit they can make?
People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend.Again, where does the rebate come from? Can't rebate something that wasn't there already, someone is losing out.
Insurers can't just drop customers once they get sick. (  Citation: Page 14, sec. 2712 )good call.
Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific). Why do i give a shit about what the insurance company does with the profit they make?
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down. If there is a detailed explanation of benefits drawn up at the start of the policy why would they have to turn down a claim? It's covered or it's not.
New ways to stop fraud are created. Can there be a more ambiguous explanation statement about one of the largest problems with our current health care system and nearly all government programs?
Medicare extends to smaller hospitals. Sounds reasonable.
Medicare patients with chronic illnesses must be monitored more thoroughly. Sounds good but the logistics of doing this could be astronomical.
Reduces the costs for some companies that handle benefits for the elderly.What kind of costs can the government reduce? Are they going to lower the price of their office supplies, phone bills, etc...?
A new website is made to give people insurance and health information. (I think this is it:  http://www.healthcare.gov/
). All government websites are awesome and helpful.
A credit program is made that will make it easier for business to invest in new ways to treat illness. A credit is rebates ugly brother, can't have a credit without a debit. All the CPAs say "oh yeah"
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers. By and large i've been having fun with this, but this truly scares me, as a business owner.
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover.good call.
Employers need to list the benefits they provided to employees on their tax forms. seems easy enough until they start dictating what benefits i have to provide. Which would be the next step.
Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.So no co-pay or charge. Translated means increase in premium.
If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners. Earners is the key word in this statement. Now i not one to feel bad for anyone who banks $1m a year but that's $10k that person could use to set up a trust for his family or $10k they could give to a real non-profit group. The problem most top earners have with this is that only 0.9% of that $10k will be used as it's intended. Waste, fraud & abuse; government specialty.
This is when a lot of the really big changes happen.
No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history. So this means everyone who qualified for insurance prior to this date will now be paying more for it to include those who didn't previously qualify. Depending on the ratios, there could be a majority group of people getting the shaft here.
If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it.This is where people get pissed because if you work your ass off and decide to self insure by stocking away your earned money since you joined the work force you still have to pay a non compliance fee. While someone who doesn't work their ass off, free loads from the government doesn't have to pay while getting the same health care.
Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. (  Citation: Page 14, sec. 2711 )Assuming the funds are there to allow this....
Make it so more poor people can get Medicaid by making the low-income cut-off higher. So where does the extra money come from. We already established that someone reporting as much as $1mil in income will only pay an additional $10k in taxes.
Small businesses get some tax credits for two years. Only for 2 years. Small business are busting their ass everyday to stay in business. This is like placating a beast with tasty morsels until you get them locked in a cage. Give them a break for 2 years and then lay it on them.
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty. Gonna be a lot of part-time employees soon
Limits how high of an annual deductible insurers can charge customers. Gov running business. As much as i despise insurance companies, i don't want the government running them.
Cut some Medicare spending. Ambiguous statements again with regards to one of the larger issues.
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. Nice penalty for self insuring...
Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. Since the exchanges and rebates are only for the lower and middle class, the upper class will be providing those rebates?
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen. Don't be so gullible.
A new tax on pharmaceutical companies. = higher drug prices
A new tax on the purchase of medical devices. = higher cost of using those devises.
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed. So the cheaper their rates and the more customers they have the more tax they'll pay. Seems legit.
The amount you can deduct from your taxes for medical expenses increases.Why play this shell game? Raise taxes to cover health care, if you use health care you get to pay less taxes. WTF?
Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in  this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read. Seems reasonable.
If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).Geez, you mean this is a union of states after all? like this is special treatment put in there just to be nice?
All health care plans must now cover preventative care (not just the new ones).Makes sense. But isn't free.
A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage). So if i choose to spend more money on a better plan i'll be taxed for it. WTF?
The elimination of the "Medicare gap" Ambiguous again.... big surprise.