Columbus residents Friday had mixed reactions on the U.S. Supreme Court’s ruling largely upholding President Barack Obama’s Affordable Care Act.
In a 5-4 decision Thursday, the Court ruled Congress has the constitutional authority to enforce the ACA mandate requiring nearly everyone to have health care coverage by 2014 or pay a fine.
Starting in 2014, most of the uninsured people in the United States — estimated at more than 50 million — could get coverage through a mix of private insurance and Medicaid.
Those who get religious exemptions, people in jail or prison, undocumented immigrants, people who have to pay more than 8 percent of their household income to get coverage, people who don’t earn enough to file a federal tax return and members of Native American tribes are exempt from the mandate.
Tax credits will be provided for small businesses to help individuals purchase insurance. (Urban Institute researchers estimate 10.9 million of the 18.2 million Americans required to newly purchase health coverage or face penalties will be eligible to receive federal subsidies to help pay for coverage and only 2 percent of the total 18.2 million population — or 7.3 million people — will have to buy coverage and not receive any federal assistance in paying for it.)
Employers with 50 or more full-time workers (or the equivalent) are subject to the law; those not in compliance — by not offering insurance or offering insurance not considered affordable — will be forced to pay penalties.
Employers with fewer than 50 full-time employees are exempt.
Additionally, the Court upheld insurance reform portions of the Act, capping out-of-pocket expenses and requiring preventative care to be fully covered. A “guaranteed issue” provision also stipulates health insurers can not deny coverage to people with pre-existing conditions.
Also, the Court withheld the Act’s provisions on a Medicaid expansion, stipulating all low-income individuals — those who earn less than $29,000 annually for a family of four — who are not disabled or elderly are eligible for Medicaid.
The Court did overturn parts of the law, allowing the expansion of Medicaid, but removing the threat of withholding Medicaid allotments to states not taking part in the extension.
“Call me a bleeding-heart liberal, but here is my initial opinion on the matter,” said Heather Williams, 25, a waitress who currently is covered under her mother’s insurance policy. “Everybody, not just every United States’ citizen, but every human being, deserves medical care, if they truly need it. Many people in this country do not receive the care they need, simply because they refuse to go to a doctor, because they do not have health insurance, and this is a dilemma they should not have to face. However, requiring everyone to have medical insurance, even at reduced rates, does nothing to alleviate the problems of lower income households.
“Even with lower rates and tax credits, that is still additional money many will be required to pay that they simply cannot afford,” she continued. “Not only that, but the problems that people complain about with the system today will continue to occur with this new system. So, you are lower income and qualify for Medicaid. That doesn’t change the fact that people on Medicaid generally receive less (or) poorer quality care, which they already receive without insurance. Nothing changes. No one is bettered by this.”
Under the terms of the Act, beginning in 2014, Williams will receive tax credits to help afford insurance premiums and assistance with deductibles and co-payments. The tax credits will ensure she does not spend more than $840 to $1,323 on premiums and her maximum out-of-pocket costs for deductibles and co-payments would be capped at 15 percent of the total cost.
When she turns 26, Williams will no longer be covered under her mother’s insurance policy and will be required to have health insurance by 2014 or pay a penalty of $95 per uninsured dependent rising to $695 per person in 2016. After 2016, the penalty will be increased annually by cost-of-living adjustments.
“When I was younger, I had very good insurance through my father’s company, and I never realized there was such a vast difference in treatment, until I was not covered under that insurance anymore,” Williams said. “It was a very rude awakening, as the cliché goes. This is simply the way it is for the majority of Americans, though. You have money and can afford good insurance, (then) you get the best care. You have no insurance or government-funded insurance and you are taken care of just enough not to die. That would just look bad on the doctors and nurses, after all.”
“I’ve kind of got mixed emotions about it,” Bruce Johnson, 34, said of the ACA. “Inevitably, as far as health care that’s more affordable and easily obtained by the general public, that’s a good thing and that’s a noble effort.
“But any sort of government mandate, it’s always going to be a negative for me,” added Johnson, a project coordinator with The CPI Group.
“I think it’s great,” said Sarah Labensky, owner of the Front Door/Back Door in Columbus. “I’m very pro with this health care plan. I don’t think it went far enough. I just think we could have done a lot more, but (Obama) couldn’t have gotten it through the Congress.”
For Amy Elsmore, 42, the ACA means her insurer cannot set a lifetime limit on benefit pay-outs or cancel her plan after she gets sick or discriminate against her or any of her three college-student children, for having a pre-existing condition.
Additionally, the ACA means annual premiums for the married paralegal would be no more than $6,440 to $7,600 and her maximum out-of-pocket costs for deductibles and co-payments would be capped at 30 percent of the total cost.
“There’s no benefits for me, personally,” Elsmore said. “I’m pretty healthy. We take care of ourselves and I don’t need someone to take care of us, including the federal government.”
She explained Thursday she’s upset with Obama and his claims about the Act.
“This whole time, he’s been saying it was not a tax,” she said of Obama. “It is a tax and that’s part of what the Supreme Court was deciding on. They said, yes, it is a tax.”
“I’ve had health care insurance, since I could get it,” she noted. “I’ve always paid into it and as far as going to a physician, we’ve had very good health insurance and been taking care of ourselves. For the people that don’t have health insurance or can’t afford health insurance, it’s not up to the federal government to tax the people to pay for people’s health care. So many people drive without insurance and who has to pay for that? I think it’s one more way to get money and make it sound good.
“We have to save our money in order to put our kids in college,” she continued. “We don’t get government grants, because we make too much money. If you don’t have money, you’re going to get health care. But it’s going to get paid for one way or another. Nothing’s free. I’m hoping it’ll get repealed later on down the road.”
“I’m very relieved that the Supreme Court upheld the Affordable Care Act,” said Bridget Smith Pieschel, director of the Center for Women’s Research and Public Policy at Mississippi University for Women. “I believe this will make affordable health care possible for my children and grandchildren. Although we are a wealthy nation, many fall through the cracks and have no health care coverage.
“Yes, this Act will be an extra expense for some who have not previously purchased health insurance for their health coverage,” she added. “In the long run, however, it will lessen medical expenses, which now force hospitals to charge insured people more than a procedure actually costs in order to cover those people who cannot pay their hospital bills.”
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