What the Supreme Court Ruling on Obamacare Means for You

Alden Wicker
Posted

Yesterday morning the Supreme Court ruled 5-4 that Obama’s Affordable Care Act is constitutional.

This Supreme Court decision is historic in that it will affect almost every single American in some way, from premium prices, to what procedures are covered, to the 30 million uninsured Americans who will now be eligible for healthcare.

Seven presidents have tried to pass legislation to mend our broken healthcare system (and it definitely could be better, as this personal story demonstrates). In fact, rumblings about overhauling the system started back in 1912, but the only huge change initiated by the U.S. government has been the creation of Medicare and Medicaid by Lyndon B. Johnson in 1965.

Now, the Affordable Care Act (ACA) and the Supreme Court’s decision promises to change everything.

Why the Affordable Care Act Is Constitutional

Opponents to the health care law don’t like it for many reasons, but the main objection that came before the court was to the individual mandate, the part of the law stating that everyone has to have some sort of health insurance. If you don’t, you’ll get hit with a tax.

According to the argument against the ACA, the government’s attempt to force people to buy a product is a violation of the Commerce clause of the constitution. What’s next? Forcing Americans to buy broccoli? This was something that Justice Antonin Scalia asked during oral arguments. And broccoli is mentioned in the Supreme Court’s decision 12 times. But the Supreme Court decided that the government wasn’t forcing American’s to buy insurance. It’s just levying a tax on people who choose not to.

Chief Justice Roberts, a conservative judge, joined the four liberal judges in ruling the law constitutional and wrote in the majority opinion, ”The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

To translate: “Is this law a good idea? We don’t know. But it sure is constitutional. Carry on.”

… Except for Medicaid

The Supreme Court did limit one portion of the ACA: The federal government cannot yank existing Medicaid funds from states who refuse to comply with an expansion of Medicaid.

In the original law, if a state refused to comply with the federal government’s order to expand Medicaid to cover all households living around the poverty level, it would have lost all its Medicaid funding.

The Court ruled that the government can offer more funds to states so that they can expand their coverage of Medicaid, and can make those funds contingent on whether or not the states actually use them for their intended purpose. However, the federal government cannot take away the funds that are already being sent to cover Medicaid in its current form.

Because states rely so heavily on Medicaid funds, the law as it was written would have effectively left states with no choice but to expand their Medicaid programs. This was seen as coercion by the Federal government, and the Supreme Court struck it down as unconstitutional.

How You’ll Be Affected

We break down the changes that affect just women in this post, but here’s what else will likely happen in the next couple years as a result of this decision:

If You Already Have Health Insurance

Requiring every person to purchase insurance is meant to spread the cost of insurance over the entire population, which should keep premiums low. If predictions are correct, overall premiums could drop anywhere from 10- 27%. That’s good news for you and/or the employer that insures you.

If You Are Older or in Poor Health

Starting in 2014, the ACA will prevent insurance companies from turning down applicants who have pre-existing conditions. Insurance companies also will not be able to charge higher premiums because of your age or health. That means if you lose your current health insurance and already suffer from a chronic illness like diabetes, you won’t have much trouble picking up new health insurance, and won’t face inflated premiums.

If You’re Young-ish and Healthy

The above provision is great for older people and those with health issues, but not so great for the young and healthy–at least right now. Young people will pay more than they otherwise would, and old people will pay less. As you get older you might come to appreciate this, but right now it would probably be an unwelcome shock to your budget (especially since younger people tend to make less).

If You’re Under 26

Then again, if you’re younger than 26, the law would help you. One part of the law that is already in effect allows children to stay on their parents’ health care plans up until they turn 26. Right now you can only stay on your parents’ plan if you do not have an option through your employer, but starting in 2014 you can choose between your parents’ and your employer’s plan.

If You Don’t Want to Participate

Many Americans won’t be hugely affected by the individual mandate. That’s because most Americans already receive public health insurance or private employer-based insurance. The remaining Americans who lack health insurance would either receive subsidies to buy private insurance or be eligible for government programs such as Medicaid. (Some lower-income Americans whose incomes don’t qualify them for Medicaid or for subsidies will be exempt from having to buy health insurance.)

Unless you are exempt, if you choose not to buy a private plan, you will pay a tax penalty. In 2014, that penalty will be $95, or 1% of income; in 2015, $325, or 2% of income; and in 2016, $695, or 2.5% of income. Further increases after 2016 will be tied to inflation. For comparison, these sums are much less than health care premiums typically cost.

If You Make Below a Certain Income

If your income is too high to qualify for Medicaid but less than four times the federally defined poverty level (four times the poverty level for a family of four work out to $92,200), you will qualify for federal subsidies to buy your own health care, so that the premiums don’t take up more than 9.5% of your income.

If You Don’t Qualify for Medicaid but Wish You Did

Some states that will probably refuse the option Medicaid funds, based on which states challenged the Medicaid provision in a lawsuit, include Alabama, Alaska, Arizona, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Ohio, Kansas, Wisconsin and Wyoming.

If you live in one of these states, probably nothing will change for you–whether you currently qualify for Medicaid or not. But if you live in a state that decides to take federal funds to expand Medicaid and you don’t currently qualify for Medicaid and live around the poverty level, you might qualify starting in 2014. If all states expand coverage, an estimated 16 million Americans would be newly covered.

What It Means for the Country

In trying to predict whether the health care law will have a positive or negative overall effect on the well-being of Americans and the health care spending of states, it’s helpful to look at two states that have instituted portions of the law:

The Individual Mandate

Massachusetts pioneered the idea of an individual mandate in 2006, requiring that residents buy health insurance or be taxed. The results?

  • 98% of state residents are insured now, a 10% rise from the previous three-year average.
  • The cost to Massachusetts of state-subsidized coverage has grown less than 3%.
  • More businesses are offering health coverage, instead of dropping it to let workers sign up with the state.

It looks like the individual mandate in Massachusetts turned out to be a success.

Expanded Medicaid Coverage

While states can decide to refuse federal funds to expand coverage, those who do accept might see a situation similar to Oregon’s, which expanded coverage to tens of thousands of residents living in poverty via a lottery. The results, as reported by The New York Times:

  • Contrary to the hopes of people who said preventive care would lower health care costs overall, newly insured Oregonians spent 25% more on health care a year than those who didn’t have insurance, and those costs were paid for by the government.
  • The newly insured reaped enormous benefit financially. They were 25% less likely to have a medical bill go into collections and 40% less likely to borrow money or skip paying other bills to pay for medical costs. They were also more likely than the uninsured to say they were in good health and getting healthier–and even, that that they were happier.
Overall it looks like states will end up paying more in health care costs, but the financial benefits to Americans could be enormous. States will have to decide if it’s worth it.
  • Lesia Milton

    “Overall it looks like states will end up paying more in health care costs.”  The “states” don’t print money, and a frighteningly large majority of them (Illinois…California) are as insolvent as Greece, so where will this extra money come from?  Taxes, in addition to the 20 taxes included in the ACA.  Learnvesters (those of us with jobs), expect to pay lots more in the future, whether you support the ACA or not.

    • Lax

      Spoiler alert: taxes have gone up every year as long as you’ve been alive.
      I have insurance, provided by my employer, so I’m lucky – but I recognize my good fortune and I don’t complain about having to help others. Let me also say: this will also drive premiums down. There ARE pros to this act and I tend to air on the side of helping everyone, vs. every man for himself.It’s starting not to shock me that this bright idea called America is on the decline after just 250 years. Everyone wants, but won’t give.

  • Guest

    Any thoughts on healthy people opting out (and paying the tax) and only unhealthy people opting in?  Do you think this will drive up the cost of health care in general because the health care system will be flooded with unhealthy people needing care?  Or do you think it will create a huge gap between private health care and public health care – with better doctors flocking to the private sector because they get paid more?

    • Jennifer

      A lot of health care use is unanticipated, and paying health insurance is a fraction of the cost of hospital care in the event of an accident or an unintended pregnancy. I think as long as the costs are kept reasonable, i think risk averse people will buy the very basic health plan option and we won’t have the “selection” problem you mention.  In terms of the two-tiered system, most managed care plans and doctors already serve a mix of public and privately insured patients. They couldn’t get by if they didn’t. Massachusetts and Hawaii are examples of states that have provided for nearly universal coverage, and have not had these problems.

    • Cams

       Healthy people need to be insured too! Accidents happen all the time. Just like car insurance, or life insurance – you never know when you”re going to need it!

    • http://twitter.com/thefinancegeek Megan Z Taylor

      I agree with Cams and Jennifer. Having health insurance, even if you’re currently healthy, is a good idea.  You  never know what could happen, and medical bills pile up quickly.

      I’m a good example of this: I’m generally very healthy and when I was phased off my father’s insurance at 23 b/c I was out of college (I’m 28 now), I didn’t get my own insurance because I didn’t have to.  I didn’t think I needed it.  

      Over the next four years (I’ve had insurance for work this last year), I fell off a ladder (faulty equipment), got appendicitis/had an appendectomy, and got bit in the face by an angry dog.  Each one of these necessitated a trip to the ER, and every single one could easily have bankrupted me.  

      Fortunately, the fall from the ladder ($7,000+ in bills) was covered by my employer (I was a freelance worker, but the ladder was not OSHA compliant, so they paid my medical bills); the appendectomy bill ($4,000+) was forgiven by the hospital due to a generous gift from one of their donors for people in my situation; and the dog bite bills ($2,000+) were paid by the owner of the dog.

      Do I think everyone should have insurance? Yes, absolutely. Do I recognize that not everyone agrees with this? Of course, that’s why the “tax” was added to the ObamaCare bill.  

      I agree that ObamaCare isn’t perfect, but I still think it’s a heck of a lot better than nothing, which is what we had before.

  • Lisamarie409

    this sounds one sided…lets draft up a pro and con opinion articles about this.articles…def getting sick of reading LV’s one sided articles…

    • Gi

      boo

    • pagangirl

      This is the internet, there are literally millions of other sites and blogs that you can go read if this one upsets your sensibilities because the writers don’t agree with you. You are free to leave at any time.

      Then again, if it really bothers you that much, maybe you should ask yourself “why.” Is it perhaps because there is a grain of truth to what they say, even if you can’t bring yourself to admit that someone else actually might be right, and you might be wrong?

      Food for thought….

    • Enibodi

      Do it.  Or go elsewhere for your complaints.

      • Snoman

        Intellectual debate is too much for you to handle?

  • http://twitter.com/shoegirlinbr Kacie

    I love how this article says that “states will end up paying more in health care costs” as thought states are somehow their own entity. The money that runs those states? That fills their coffers so they can then offer social services and entitlement programs and expanded services? That money doesn’t appear out of a vacuum. It comes from TAXES which working Americans pay. Some of those Americans will have a tough time even coming up with the $695 tax that is now imposed if they decline insurance. So how does that help them? You penalize those who cannot afford insurance even if they live above the “poverty line” by charging them an unnecessary fee? To say that the “states” will pay more is more than a little disingenuous. States do not generate revenue or profit – they collect revenue from those of us who go to work and earn a paycheck.

    Am I saying that in a country such as this where there is plenty that everyone shouldn’t have healthcare? Absolutely not. But I believe in solutions designed to help people transition into independence rather than mandated, government-backed socialized programs in a free enterprise-based republic. When FDR created the New Deal, initiated Social Security and attempted universal healthcare, he gave us a society that expects everything rather than paying their own way. The same is true of welfare. It was meant to be a way to transition from dependency to independence. It was meant to be a short-term solution in times of loss or unexpected financial hardship. It was never designed to be a permanent way of life for generations of people. But the ACA is predicated on services like this which have come to define a entire segments of the population who refuse to work because it’s more critical to Occupy Wall Street and expect someone else to pay their way because they can’t.

    I’ll leave it to Thomas Jefferson to state it best: To take from one, because it is thought his own industry and that of
    his father has acquired too much, in order to spare to others who (or
    whose fathers) have not exercised equal industry and skill, is to
    violate arbitrarily the first principle of association, “to guarantee to everyone a free exercise of his industry and the fruits acquired by it.”

    • Bbeauregard54

      I can’t agree with you more, you are so right. It’s so true about welfare, I know some ppl who are making a living on welfare and passing it down to their children. also the s.s disabillity, they are on that and I know them and they can work but they take the easy way out, and someone like me who has been working since 16, I am now 58, would like to get on it, cause I have a cyst in my brain, which causes random seizures, can’t cause my husband makes too much money. Although he does we do have lot’s of bills and try to keep out of debt. All I can say is why don’t the Left wake up and smell the coffee.

      • Jsm_jpc

        Bbeauregard54 does not the new provision now make you eligible for Midicare/ Medicaid ot at least for the subsidies for insurance?  Aren’t you now able to get better insurance for this pre-existing condition?  You are a prime example of who benefits from these new mandates.  So what us your point?

        • Anne1952

          I started working at age 12. I worked all my life until a few years ago when I fell and injured my back. Can I get disability at 61 years old? Well I could if I was crazy, or a trans-sexual, or even a drug addict. But no. Can I work? No. Can my husband find a job? Sorta, he does odd jobs, mows lawns, hauls stuff etc, anything to make a buck. He’s been looking for a job for 2 years, but his age and size are against him.

          We live way below poverty level now and I can’t get medicaid, go figure. If I could get help for my back I might be able to go back to work. So I don’t think there’s going to be any help for us no matter what goes down with this.

    • Jsm_jpc

      Anyone who has had to go to the doctor even for a one time incidence will tell you that the $695 is far less than the bill they incurred and are responsible to pay.  I was unemployed and had a one time health issue.  I have no health issues, but a recent visit to the ER cost me more than $3000 out of pocket.  I would have rather paid the $695.

  • kelly

    I am concerned that doctors will be refusing new patients or leaving practices which will greatly limit our options for healthcare, affordable or not.  It doesn’t work in Europe, not sure why peoplen think it will work here.  Happy for people who can’t afford healthcare, worried for those who will be paying for the healthcare those people receive.

    • Jennifer

      We pay one way or another now. The “free care” they get when sick gets added to our bills. And government programs for the poor and elderly are already subsidized by our tax dollars. Except for the very high end few doctors (think Madison Avenue), almost every doctor in the U.S. already sees a mix of public, private, and uninsured patients. Overall, bringing eveyrone into coverage adds stability.

  • http://twitter.com/thefinancegeek Megan Z Taylor

    Regarding the final point made about Oregon, part of me wonders if the newly insured spent 25% more on health care than their uninsured counterparts because the uninsured were less likely to get health care in the first place? When I didn’t have insurance after college, I never went to the doctor, or even the hospital.  

    I also wonder if the newly insured spent more on health care because they were still using their old habits of going to the emergency room (instead of a primary care physician) when they had even a minor problem.  

    Overall, I think the fact that “ObamaCare” was deemed constitutional (for the most part) is a really great thing.

    Also, I love the way you summed up Justice Robert’s comments. :)

  • Velvetr1966

    Any of you who say it doesn’t work in Europe or Canada have been listening  to way too much conservative rhetoric.  I have been to Euope many times, they do not understand why we all dont have health insurance, they love theirs.  And I have many Canadian friends who cherish their health insurance.  The only issue we will have in America is greed, but hey we have that already.  The majority of Americans are close to the poverty line and yet we may have docs leave their practises because they are making less money?  That won’t last long.  They love money too much.

    • Roryandrenee

      Unlike European countries and Canada, American physicians are in debt up to their eyeballs.  Undergraduate, medical school, years of low paying residencies.  Of course physicians need to be paid, they owe too much money for their medical training.

      If, however, you want to offer free medical school (see Ireland or Italy for example — or even Canada which offers affordable education) then I think you can talk about greedy physicians.  As is, most that I know are simply treading water to pay back their student loans.

      • Guest

        I agree. I don’t think of doctors as “greedy”, they invest too much time and money into their education and should be rewarded higher salaries than the average citizen. Plus they are under a lot more pressure once they get into their field because of the pressure of malpractice cases. 

      • Guest

        And what about when they’re done paying it all back? It doesn’t take many years on a Dr.’s salary to pay back student loans. Period.

        • rk

          Really?  How about this:  4 years of undergraduate school at approximately $50,000 per year.  Same thing for medical school.  So that is $400,000 you owe (a conservative number).  Then you do, say, a four year residency at which you earn maybe $55,000.00 At this stage you are 12 years into your training or about 30 – 32 years old.  You may want to get married, start a family but only now are you starting to earn a living, maybe $200,000 per year.  Don’t forget your taxes as that $200,000 isn’t as much as it seems once all the deductibles are taken out.  And don’t forget your medical malpractice either.  

          • Anne1952

            Yes and God forbid they should have to drive less expensive cars, stop wearing mink coats, or miss out on the opportunity to play golf or eat and drink in the best places 7 days a week. They certainly earn that $100-$700 office visit fee in the 2 minutes they spend with you too. Really? They see at least 1 patient every 15 minutes, in an 8 hour day that amounts to a MINIMUM of $3200 a day, assuming they only work 8 hours of course. That’s more than most of make in 2 MONTHS. And yet they refuse to help someone who is in desperate need of health care because they can’t pay? Please, spare me the tears for those poor doctors.

    • Ph0t0journey365

       I have family in Canada. My father returned there more than a decade ago; my sister moved there four years ago and became a full citizen. Yes, they have health care. Can they even get emergency care without their “primary health care” physician recommending it – NO. Despite prolonged and sometimes disabling health problems, have either of them been able to see their PCP? No. My dad has been waiting SEVEN years to see his PCP on an appointment. Don’t even ask about an unscheduled visit.
      I don’t have health insurance. Haven’t for years. Went through pneumonia on my own. Save money to pay for discounted services at the clinic only when necessary. Insured folks go to the doc for the sniffles instead of doing Nyquil, herbal tea, and rest.
      Proof of hospital and medical industry corruption and greed: My son, just 18, got bitten by a rattlesnake. The ambulance coerced him into going when he repeatedly told them he wanted me to drive him to the hospital. Charged over $800. The hospital would not let him take the IV and go home where I could administer the anti-venom to him as recommended and forced him, against his wishes, to stay in ICU under constant supervision. The cost of “medication” and anti-venom alone was over $148k. If my son had been a dog of the same weight, he would have gotten the same anti-venom, the same overnight supervision, pain meds, and a bill that would have only totaled about $3000. ACU won’t fix medical greed or corruption. It will only fill the pockets of the insurance and medical industry who paid Obama and the politicians to pass this b.s.

      • Tellitlikeitis

        Something about your story does not add up. Nobody waits 7 years to see doctor in Canada..simply not true. Stop with the scare mongering!

  • Stefanie

    I can’t wait to see how this turns out. All the negativity by conservatives with no proposed solution is sad. I am proud that someone….anyone! is doing something about our troubled economy. If you don’t like the decisions made by our government come up with your own and run for office. Otherwise, give the proposed ones a chance to prove you right or wrong.

    • luv2graze

      Hey we’re working on it, I’m doing everything in my own little world to make sure that our current President does not get re-elected. What people fail to realize is that we should be more afraid of the other parts of this bill that are not health related.
      Once again, I’m being forced to cover the behinds of those who can’t pay their own way. Even though an “un insured” individual CAN get medical help when needed. Recently a co-workers daughter had to have surgery and was in ICU for several days – guess what no health insurance and yet magically she was treated.

      • http://twitter.com/thefinancegeek Megan Z Taylor

        “Magically she was treated”?  Well, of course she was treated.  That what the Hippocratic oath is all about: “Do no harm,” etc. It doesn’t say, “Do no harm, except where the patient is uninsured, and then you can choose to treat them or not.”

        And I think she should have been treated, especially if she needed to be in the ICU for several days.  I just worry about how much treating uninsured people costs the rest of us in ways that we don’t really hear about.  

        If you have insurance, and something is wrong, you go see your primary care physician. If you don’t have insurance and something is wrong, you often end up in the ER, because where else can you go?  The ER is an expensive place to land, insured or not, and if you’re uninsured, someone has to foot the bill.  If it’s the patient, that can easily bankrupt you, and if it’s the hospital, those costs get spread across the rest of the patients.  

        Just because an uninsured person CAN get medial help if it’s needed, doesn’t mean that medical help is the best, or most efficient form of medical help, or the least costly.

        • No Way Jose

          My husband died of cancer a few years ago. He refused to buy insurance because “he had the blood pressure of a 12 yr old and would outlive me”… jokes on him! He got treatment thru medicade and after he died, I started going to a low-cost clinic. It still costs me something, so when sick I weigh the cost of the visit and how much money I have vs. how sick I really am and whether I can wait until the following month for medical care. Under Obabmacare this choice would be taken away from me. I would have no choice but to buy insurance and because I can’t AFFORD it, YOU will SUBSIDIZE my monthly premiums.  Now instead of going to the clinic maybe 3 times a year with a bladder infection, I will now go any time I have a sneeze or a splinter in my finger and YOU and your friends will cover the costs. Welcome to socialized medicine!

      • http://twitter.com/booglesclash booglesclash

        I would like to point out that there may come a time when you are unable to pay for insurance and need emergency services. If someone is sick enough to be in the ICU, then that person deserves treatment, regardless of whether or not she can pay for it. Personally, I have private insurance and feel grateful that I can afford coverage and other necessities. Some people aren’t so lucky. If you’re concerned about having to pay into a system from which others benefit, then perhaps you are not planning on ever collecting social security after retirement or relying on Medicare for health costs? Our government has relied on taxpayers paying for others long before President Obama came into office.

  • Elle

    A mega-budget-busting, tax-raising, economy-crashing, ginormous government oversight boondoggle that will hurt far, far more people than it will possibly help. Vote to repeal Obamacare. 

    • http://twitter.com/thefinancegeek Megan Z Taylor

      I’d be very curious know how you think it will hurt “far, far more people than it will help.” 

      Right now, I can name six people I know personally that ObamaCare has helped (and I don’t know anyone it has hurt), and it’s not even fully taken effect yet.  After it takes effect, it will help those six people even more.

      • Mary

        Please explain how it helped each of those six people, just curious.

        • http://twitter.com/thefinancegeek Megan Z Taylor

          Mary, ObamaCare has helped:
          1. My sister, who was able to get some much need health and mental well-being care when she was put back on my father’s insurance for two years (from ages 24-26).  As soon as ObamaCare takes full-effect, she’ll be able to get her own insurance at a price she can afford, and won’t have to stress out about the idea of getting hurt or sick and not being able to pay the bills.  She makes just enough not to qualify for Medicaid right now.

          2. & 3. My grandmothers, both of whom use Medicaid to pay for their medications, and have been hit by the “donut hole” in prescription coverage which ObamaCare is closing. The biggest compliant against this aspect of  ObamaCare is that it would raise prescription costs for Medicare by dis-insentivizing prescription of generics during the “donut hole” period.  The only problem with this argument is that many of the drugs my grandmother’s take don’t HAVE generics, so they’re forced to pay $600+ a month for prescriptions until they get to the other side of the hole.

          4.  & 5. My mom and step-dad, who are self-employed and paying their own insurance.  By requiring more healthy people to have insurance, ObamaCare means that the burden they’ve currently assumed by being healthy and having insurance will be spread over more people, therefore lowering their premiums.

          6. My good friend, who had a heart-attack at a very young age (24), despite being otherwise healthy and fit.  She has been unable to get any insurance company to really deal with her because of her pre-existing condition.  I don’t know if she’s been able to get coverage yet, b/c the pre-existing condition piece of the Act doesn’t really go into effect until 2014, but at that point she’ll absolutely be better off.  

          I guess I can really only say five, since I don’t know that the sixth person is currently benefiting.  But I still don’t know anyone whom ObamaCare has hurt, or would hurt.

      • No Way Jose

        How can it hurt? Well I for one cannot afford health insurance and resent being told that if I refuse to kow-tow to Big Brother Obama that I will be penalized with a fat tax (talk about knee-capping!)!

        Oh right, I forgot! If I can’t afford Obamacare, YOU and YOUR FRIENDS will subsdize MY health “insurance”! Smells like socialized medicine to me! Better open up your wallet…

        • http://twitter.com/thefinancegeek Megan Z Taylor

          Question: What’s wrong with “socialized” medicine? I’ve been in three countries that had so-called socialized medicine that I was, as a foreigner on a visa, able to take advantage of.  Everyone there seemed to think it was amazing that Americans had to pay so much for insurance.  

          Sure, the people in these countries paid more in taxes, but the benefit was that they were able to get treated for  any illness or injury without the fear of losing all of their money.

          Call me a socialist if you want to (I’m actually a moderate), but having seen first hand the benefits of “socialized” medicine in other countries, I am happy to “open my wallet” and pay more in taxes if it means that more people, including many members of my family, will be able to live without the fear of medical-bill-induced bankruptcy hanging over them.  

          Additionally, the idea of ObamaCare (and other universal health care proposals) is to (eventually) lower the costs of healthcare for everyone.  In order to get to that point, we have to take the steps we’re currently taking.

    • Lee

      More people will have health insurance…how exactly do you think this “will hurt far, far more people” How do you think this will hurt anyone? What do you even mean when you say hurt? I believe you  mean some people will have to pay money for health insurance. That’s not hurtful to anyone, maybe annoying, possibly inconvenient, but people need health insurance. Health insurance helps people.

    • janet

      I am unawareof your circumstances or age but speaking as a 62 yr young woman who 6 yrs ago lost her home because of medical bills I am happy to say the bill is constitutional. No tax paid if u enter system and when u need health care god forbid u will reap the benefits 

  • Eglos1986

    Im not sure about this. Granted, I do have Medicare and Medicaid because I am disabled, but my fiance doesnt have any coverage. I do not think that it is right to force people to get health insurance. And yes, to me, forcing a tax for not having it is forcing you to get it. I just do not know what will happen and cannot even being to speculate

    • Jen H.in MA

      The reason it’s right, logically, and why it’s not the same as being forced to buy broccoli, is that healthcare is a unique class of  ”consumer good” unto itself–a service that virtually every person in America is guaranteed to demand, require, and receive. And it is so expensive that it is logically unfair that a certain group of folks simply opt-out of contributing to paying the costs. Every American could live their whole life without consuming broccoli. Conversely, it is basically ASSURED that each of those Americans WILL need, seek, and receive health care–not just at some point, but fairly regularly, throughout their lives, and at significant cost. 

      While it’s legal for a grocery store to “decline” to give away free broccoli, the same can’t be said for healthcare. It’s generally not legal to simply deny care to an urgently ill person who shows up in the ER. Besides, doctors won’t go for that, having taken an oath to care for ill humans, period.

      I suppose if people could choose to carry an opt-out card that read “untreatable; no insurance; do not bring me to any healthcare facility or allow any healthcare to be provided to me unless I am able to pay cash up-front for any/all recommended services” then I’d be okay with their foregoing a regular insurance policy. But most people say that any kind of automatic denial like that would be grossly unethical. Instead, people are able to seek whatever treatment they like. So to pay a tax that is but a fraction of the cost of the real healthcare plan they should have been carrying seems like a bargain, and to oppose it seems like social-responsibility-cheating to me.

      • No Way Jose

        Break out the baseball bat! You either pay Obamacare “protection”, or he’s gunna knee-cap ya with a fat tax guarrenteed to go up every year until you finally break and pay up!

        • http://twitter.com/booglesclash booglesclash

          I appreciate your humor here. However, the supposed “fat tax” is nothing in comparison to the cost of a monthly insurance premium. My insurance costs roughly $5,000 a year. The 1% tax is nothing compared to that. Further, this law will help individuals (such as myself) that have pre-existing conditions.

  • Shannon

    This plan may not be perfect (Obama has had to make a lot of concessions he didn’t want to make) but what is the alternative? Oh wait, no one has offered an alternative! There’s a reason why this was on the table in the first place: our current healthcare system does not work, not only for those currently uninsured, but also for people like me who do pay for insurance. Something had to be done and there is a lot of good that will come out of this plan that many dissenters will reap the benefits of very soon, if not already. 

    I really can’t understand why people don’t see the value in having universal healthcare. Bad things happen all the time, no one is invincible.

    • Onwidit

      In truth, Obama didn’t write this plan.  Hillary Clinton did, 20 years ago.  He’s just taking credit as usual.

      • Shannon

        Thanks for the clarification. Does that matter? He’s taking the credit and the heat all at the same time – which isn’t really the important part anyway. The important part is healthcare for everyone.

      • Natalie Regier

        I don’t know if this is true or not, so I can’t say, but even if it is, that’s the entire political world.  There’s also clear evidence that George Bush the first was responsible for all the foreign relationships and economy changes that took place Reagan’s presidential terms. (again, true or not, sadly, it happens allll the time)

      • Meganrshepherd

        Mitt Romney came up with the individual mandate idea when he was governor of Massachusetts.  He should be taking credit for his own ideas, which obviously proved to be beneficial to MA…

    • Jen H. in MA

      Dissenters are already reaping the benefits.  Here in Massachusetts, the news has widely reported the fact that the Massachusetts Republican Senator Scott Brown and his wife continue to carry their adult, college-graduate daughter on their health plan, despite being millionaires who could obviously just give the grown daughter the cash to pay for her own plan if they simply want to help her out (nothing wrong with that parental desire!), rather than having US taxpayers foot her bill (assuming it’s his fabulous Senate/Gov health plan) or unduly burdening the insurance system in general..or…dare we point out…letting Obamacare, the system he professes to detest, insure his own family.

  • Guest

    If You Already Have Health Insurance
    Requiring every person to purchase insurance is meant to spread the cost of insurance over the entire population, which should keep premiums low. If predictions are correct, overall premiums could drop anywhere from 10- 27%. That’s good news for you and/or the employer that insures you.  – Wow, is that why my employer required me to pay 30% of the premium two years ago when this was passed because they were expecting an INCREASE in premiums?????  Hmmm….pondering the answers to this question….

  • janet

    What about those of us who have a small business with employees and can’t afford to offer insurance? We might as well just close the doors.

    • http://twitter.com/thefinancegeek Megan Z Taylor

      Situations like yours are the reason I’m sad that everyone, including the president, has shied away from the single-payer system.  I think it’s ridiculous that healthcare is tied to the employer.  I know the historical reasons why it turned out that way, but it’s led to all sorts of tricky situations where small businesses can’t afford to provide health care, and people can’t afford to leave jobs they don’t like because they can’t live without insurance. 

      The best reform would be to separate health care from employment, but no one seems willing to do the work to move down that road.

      • Cams

        I completely agree, Megan. It makes absolutely no sense to link health care with employers. The health care bill started out as single-payer but was significantly watered down during the negotiation process because conservatives were afraid it was “socialism.” Too bad, but this is a step in the right direction..

    • Meganrshepherd

      Companies with fewer than 50 workers won’t face penalties if they don’t offer insurance. If you have 25 or fewer employees and a work force with an average pay of up to $40,000, you can get tax credits to help buy insurance: up to 35 percent of the cost of the premiums this year, rising to 50 percent in 2014. (You’ll have to pay at least half of the total premium cost or 50 percent of a benchmark premium to qualify.) Full credits will be available for the smallest firms with the lowest-paid workers (10 or fewer employees and average yearly wages of less than $25,000); the subsidies shrink as companies’ size and average pay rise. The tax breaks – estimated to affect about 12 percent of employees covered by small-group insurance — will last for the first two years a company buys insurance through its state exchange. The breaks should lower the cost of insuring affected employees by 8 to 11 percent, estimates the Congressional Budget Office.

    • Jen H.in MA

      Good news! Your employees will be able to purchase their own plans now. As long as you’re paying them legally, they should be able to get coverage–on a sliding scale, too, if you don’t pay well.

      • YL

        oh and he forgot to add the part that you would also have to pay a penalty fee for not being able to provide health coverage to your employees.

  • janet

    Health care did need to be reformed. I have a son who has had 3 open heart surgeries–pre-existing condition so that is a good thing. Again reform needed but let’s be realistic.

  • Cynex1

    Auto insurance is mandatory too, supposedly, but there is no tax if you don’t have it and no federal “program” to help you pay for it if you can’t. A bunch of BS if you ask me.

    • Cynex1

      The BS is the mandatory order to buy insurance or be taxed to pay for everyone elses insurance.

      • Jen H.in MA

        It’s only BS if the folks who don’t buy it actually cannot GET healthcare without it. But uninsured people get care ALL THE TIME at the expense of those of us who pay into the system. So give me a break. If you can find me 3-million Americans who, from conception, through birth, and until death, never received any form of healthcare for either him/herself or his/her kids, then I’ll be ready to eat my words, even though that would represent a paltry less-than-1% of the population.

      • http://www.facebook.com/people/Alexis-Elizabeth-Drob/1653803071 Alexis Elizabeth Drob

        Yes and everytime some punk kid hits a telephone pole with his car while texting his girlfriend my auto insurance hits a new high!!! Everyone is FORCED to buy auto insurance whether we can afford it or not, if we don” buy it, we lose our drievers license and/or go to jail / or get fine thru the a**. So who is being forced!!!

      • Carl N

        if argued liked that it probably wouldn’t have passed, but ACA opponents failed to do so during legislation.  When a law is passed, and deemed constitutional it is the law.  Elections have consequences. 

    • Natalie Regier

      Exactly, but, it’s also only mandatory if you buy a car, but you don’t have to buy a car. How would it go over if you HAD to buy car insurance, even if you didn’t have a car…it wouldn’t!

      • Ruebix78

         I understand where people are coming from, saying that you have the option not to own a car if you don’t want to pay for car insurance.  But that argument falls apart when you realize it is entirely possible to live your entire life without a car, but not without using medical services.  Even the healthiest person alive is going to have to visit the doctor at some point.  Many people can afford yearly visits without health insurance, but one medical mishap – broken leg, appendicitis, not to mention things like getting pregnant and having a baby, and the costs of medical care become unreasonable.  I’ve gone for periods of time without medical insurance and have been fine, but I was always nervous about what would happen if I got into an accident or something.  When I was unemployed I still managed to pay my car insurance, and there was no system in place to help me.  It’s reassuring to know that if I’m ever in that situation again, I should be able to find some way to keep health insurance.

        • sonyarae

           yes, people do run into situations where medical services are needed, however, I would rather pay for the service I’m receiving not services I don’t receive. some would argue that this is like getting a cafeteria (multiple options for one price) insurance plan. in theory it sounds great but again, it’s outrageous that i’m being required to do this. totally unconstitutional.

          • Cams

            You say this until something happens to you or a family member and you get a ridiculous bill that would have been mostly covered. Medical costs are not the same as other consumer goods. When you’re hospitalized you’re not thinking. “Gee, is it financial responsible for me to accept this very expensive treatment that I need to be well? The treatment I need to continue working so I can continue getting my employer-based health insurance?” Absolutely not. You take the treatment regardless of the price tag. The laws of economics simply do not work in the medical realm like they do elsewhere.

      • Cynex1

        I agree, I am not saying that is what the government should do. If you have a car , you have to have insurance. But, we have had an accident with someone that didn’t have car insurance and so do you think she got into any trouble? A ticket, a fine ? Nope. She walked away without anything and we had to pay for it ourselves. That was quite awhile ago, but why is it that there is no fine for them? When you go to get your license renewed, you should have to show proof of insurance. A car accident can wipe you out as well. They just don’t enforce it. The government is not consistent. A bunch of crud if you ask me. I don’t see much good coming from this Oblahblah care.

      • http://www.facebook.com/people/Alexis-Elizabeth-Drob/1653803071 Alexis Elizabeth Drob

        Don’t give our governement any ideas, they are listening ya know…lol!!! They just might take it in their heads to try that.

      • Cams

        Yes, it would be absurd to ask folks without a car to purchase car insurance. But EVERYONE needs medical care – regardless of how healthy you are.

      • dj

        depends on the state you live in also if you dont have insurance in some you will lose the cars registration and your drivers license.

    • http://www.facebook.com/people/Alexis-Elizabeth-Drob/1653803071 Alexis Elizabeth Drob

      Finally someone i can agree with here!!

    • Cams

      The tax is a huge ticket from the police officer…or possibly getting sued!

  • John

    The best single summary I have read anywhere.JCB

  • Canadian78

    I live in Canada and am currently going through chemotherapy, radiation, surgery and take prescription meds and do not pay $1 more than my insurance premiums. I can guarantee you that without insurance I and possibly some family members would be bankrupt for paying for my treatments. Medicare is a right and privilege that should be afforded to everyone. And someone has to pay for it right?

  • Natalie Regier

    As a young healthy person, my costs have already gone up.  I had to raise my deductible to $5000 just to have the same monthly premium.  I think it’s problematic when the government takes a problem (high cost health care) and instead of finding a way to lower it, we just spread the problem to everyone.  
    I think the article above is quite informative, but also biased.  3 stats from a state-enforced health care law can’t assume that it will work the same for a federal law.
    Also, as the last paragraph states, “overall it looks like states will end up paying more in health care costs, but the financial benefits to Americans could be enormous.”  Where do states get their money?  from the “Americans that are getting the ‘benefits’”…this stuff isn’t free just because our government “pays” for it.
    I think Chief Justice Roberts was also wrong.  If it’s okay for governments to charge it’s citizens for NOT doing something, then that’s in effect, forcing them to do something.
    Costs will continue to rise and we’ve just made the health care problem worse, and it’s no more reformed than it once was.

    • Mary

      For them to say that the cost of premiums will go down, is BS. Some Insurance companies have already started raising the premiums just in anticipation of this bill. My husbands employer called a meeting which included a representative from the insurance company, right before their time to renew their insurance and he stated that everything was changing, so that would affect what they could afford to pay and afford to have coverage on.  His employer has always paid their premiums in full for his employees, since they are a small business, now each employee pays a portion, which isn’t a huge deal, but they went from 90/10, $350.00 deductable, $15.00 co-pay, $5.00/$10.00 prescription cost, to what is called, Small Business/High Deductable insurance. Each employee now pays over $375.00 a month, with a $5,200.00 deductable, that pays absolutely $0, until that deductable is met. That includes prescriptions that have to be paid in full out of pocket, so two of the medications that I needed I had to stop taking because I can no longer afford the $400.00+ a month that they cost. The rep. from the insurance company did bring up the rise in cost is coming from insurance compainies preparing to lose money due to Obama care. So, please, I want someone to explain how they think this is going to be better for all of us, because right now, I am not seeing it.

  • Ccourage

    “In trying to predict whether the health care law will have a positive or negative overall effect on the well-being of Americans and the health care spending of states…”

    This is important, LV, but frankly, I’m more concerned at the moment about MY well-being and health care spending. 

    How much more/less do individuals in Mass. now have to pay for their premiums?

    • Jen H.in MA

      I’m in MA. We’ve had this system for a while now, and I’ve been on a few plans as our family status has changed with job changes, new baby, starting a small business etc. In general, there has not been much difference than before, cost-wise. Premiums have increased annually, in all states, I think, over the past decades. One notices the changes mostly when filing tax returns (have to submit your “insured” certificate or fill out the tax penalty form) or changing plans (much easier just to purchase one’s own plan, regardless of employment). I have to tell you, the move to MA Universal Healthcare just has not ended up being a contentious issue here. I never really hear anyone talking about it, much less arguing. It has basically worked okay, I think, and the upshot is we have 98% of residents insured properly and, I believe, 100% of children. I don’t mind paying my part in that success.

      • Ccourage

        Thanks, Jen. Glad to hear it’s working out for you.

  • LD

    I think it is irresponsible for a financial website not to even mention the effect of this law on our national debt, which is approaching $16 trillion. full story, please.

    • http://www.facebook.com/people/Alexis-Elizabeth-Drob/1653803071 Alexis Elizabeth Drob

      Sorry but the republicans lost, get over it and accept it. Politicians are the reason the country has such a huge debt and it is no fault of the citizens of this country. The debt will no doubt get higher  and a solution to the problem will never come, in spite of our efforts to get it under control. So healthcare is done accept it and move on.

      • Mary

        So sorry too, but all you libs keep telling us is, to get over it, NO, I will not get over something that I think was done against the will of most Americans. This is something that should have been voted on by the people of the US, not just thrown at us and  told like it or lump it. This is America, where freedom of choice has always been an option. This is not some communist country where things are shoved down our throats and we  have no choice in anything. But, unforetunetly it’s fast becoming that way. This is just the beginning of losing more of our freedoms, whether it be freedom of choice, freedom of speech, or freedom to bear arms, it’s all in our future. so DONOT tell me or anyone else to get over it and accept it, it won’t happen and the fight for our freedom to all of the above is not over!

        • Steph

          The basic principle of the law is very similar to that of the basic principles of food regulations, the Consumer Financial Protection Bureau and age restrictions on driving, drinking, and smoking. The government is creating regulations around industries to ensure that the people are protected from a company that may or may not have your best interests at heart. 

          It is through consumer protection legislation that the government is serving one of it’s primary purposes. 

          So no, do not get over it. Instead, be glad that more kids will have easy access to the shots they need and will spend more days in school and playing then in bed and ill. The same way that when an age minimum was enacted by government on purchasing cigerattes, parents were glad their kids no longer had such easy access to such a harmful product. 

          This isn’t a partisan issue. 

        • JG

          Umm, Mary, you’re aware that you always have the right to touch base with your congressman on your opinions, right? They didn’t just “throw it on America” there was a vote that you could have swayed through appropriate communication with your local elected offices. If you didn’t vote or voice your opinion you should get over this battle and actually be more politically active kiddo.

      • LeAnne

        The solution to most debt situations are to spend less than you make and put the excess towards the debt.  And though there is plenty of fault to go around, everyone should take control of their own responsibilities for the situation.  It seems that many people want the government to provide more and more without being willing to pay the government more and more. 

    • Guest

      And how will this affect our national debt? Do you know? I see lots of predictions going around but, ultimately, few of us know. From what I’ve read it appears that the initial costs will be higher but ultimately it will even itself out because we’ll have a healthier population and fewer tax dollars footing the bill for uninsured people.

  • M. in Ohio

    Did I miss the part about women’s premium costs lowering? Our costs should become more comparable to men’s right? That’s what I care most about – I pay over double what a comparable male would at my place of employment so I’d like to see some action there.

    • Mary

      In my 61 years I have never seen medical insurance premiums ,that is offered through an employer, differ between male and female. Life insurance yes, but it is opposite, women pay less than men. What company do you work for and what insurance company is it with?

      • M. in Ohio

        Everyone tells me the same thing Mary! I don’t understand it. I work for a non-profit and have insurance through Medical Mutual via my employer. Not sure why it is that way, but it is aggravating.

        • Mary

          To say the least. That is discrimination at it’s finest and I always thought that about life insurance. How do they know which sex will die first, because it’s not always the male. I know a lot of men that are widowers at a young age. Oh well, thanks for replying, it just isn’t anything I have ever heard of before with medical insurance.

      • Guest

        I suspect she is referring to the cost of what many consider to be only “women issues” or, namely, child planning / female sexual health. To add that to my current healthcare plan would raise my overall costs about 70% a year when all is said and done… Which is kind of ridiculous. You can see this on any insurers website when you get quotes.

      • AldenWicker

        Hi Mary, 

        We explored this issue in this blog post: 

        http://www.learnvest.com/2012/06/what-women-on-a-budget-love-about-the-affordable-care-act/ Overall, women do get charged more for health insurance, though not always, and the ACA tries to address that by banning gendered pricing. Hope that helps!

    • Guest

      During President’s Obama’s address yesterday he did say that women’s premiums would go down (I think implying they’d become comparable to men’s)…

    • AldenWicker

      Hi M, 

      In response to your question, I wrote up this blog post on the elements of the Affordable Care Act that are just for women: http://www.learnvest.com/2012/06/what-women-on-a-budget-love-about-the-affordable-care-act/ Thank you for raising this very good point! 

  • Laniraes

    Let’s just be honest: no one knows exactly how this is going to hurt or help people. We’ll see when it’s implemented. I’ll be honest; I’m not crazy about it. When pelosi herself says they don’t know what all’s in it, then who really knows? Nobody really does. We shall see.

    • Cynex1

      Not to mention that non of this mess applies to Congress. They still have their great insurance coverage and will until they die, just because they served maybe a few years in office. If they don’t like the plan, why in the heck would I? Something sticks about Obamacare.

    • Guest

      I suspect that it’d be easy enough to find a comparable situation in another developed nation that enacted a similar measure. The data might be a bit off due to a few key differences but I imagine it’d help us for a smoother transition if we looked at some of the errors or negatives that others faced in similar situations.

    • Katherene`

      @Laniares – you’re right!  We don’t know how this is going help or not.  But it’s all we got for now.  So let’s hope for the best. 

  • Ro

    As a person who was able to have life-saving surgery last year because the ACA allowed me to go back on my parents’ insurance, I’m pretty glad the Supreme Court thinks it’s ok.  I’m back to being uninsured now that I’m 26, but my tumor-free guts thank Mr Obama every day.  Now I’m just hoping that when all of it goes into effect (esp the mandate), there will be more affordable insurance available.

  • Lisaml1972

    I am very confused on how to feel about this… I have heard a lot of good points and quite a bit of bad… I guess bottom line is no matter who you are, even the president….cannot please everyone… What works for one person does not work for the next… So the question I need to ask myself is what works for me?

    • Katherene`

      @Lisam1972 – It is confusing, but just try to break it up into pieces.  And the parts you don’t understand will evantually addressed over and over again.  That’s how I learned to understand this whole big “Elephant.”  And I’m still learning and trying to understand it too.  You’re not alone.  Cheers!

  • Mary

    So, to keep me from having to read the entire ACA documents, can anyone tell me when the pre-existing condition clause kicks in? I know that right now, as long as you have continuous coverage without a break for more than 63 days, they can not hit you with the PEC clause. But, we are looking at getting private insurance and, as of two days ago, we have been turned down from several due to my husband being a Type2 diabetic and me having Lupus. Same as with life insurance, no one will cover him or me, not even his life insurance that his employer offers.

  • Laura

    Thank you so much for this lovely article.  There is so much confusion surrounding this issue, and I believe it is due to lack of knowledge on it.  You have put it simply and impartially.  I wish that many “professional” journalists would follow based on your example.

  • http://twitter.com/PattyOnMoney Patty Grabiec

    Thank you for the fantastic explination! I will be showing this article to others who have questions about this new situation.

  • Alicia

    Absolutely wonderful – I feel that I have a much clearer understanding of the implications of this change than I did before. Thank you for your lovely and well-written article!

  • http://twitter.com/misshowsy Cindy Heiser

    Thanks for the explanation.  It would also be helpful to hear how  this program compares to other socialized medical programs throughout the world and how it has forced Europeans and Latin Americans to seek specialized medicine in the US up until now.  The reality will be the dumbing down of medicine in America and therefore the world. 

    • Allison S

      Hello I live in Australia, a country very similar to the USA. Like every other Western civilised country we have the same subsidised healthcare have for >50 years. What it creates is more choice: when I have a baby or if I were ever in an accident, I can choose to pay for private cover or default to the government subsidised hospitals. Most people use the government-funded hospitals because they are equal or better quality. 
      Its the same for friends in Europe and Canada. I can refer you to some studies if you’re interested in reading some academic literature rather than a lot of the baseless rhetoric that appears in the comments on this site.  Congratulations on finally passing a law every other western country considers a human right, equivalent to the right to vote, and the rest of the world is proud of the US for catching up.

  • Comments

    Thank you. There doesn’t seem to be much good in this for my age group. Healthy 30-40 year olds who can’t afford health insurance now seem like they’re going to be FORCED to buy at a higher rate, or pay fees soon that are quite shocking after the first year. I own my own business and struggle. Because I’m female and in the age bracket of having children- to insure me would break the bank. So, I work out and eat right instead. And now, I shall be penalized for that. 

    • Respiratorymandl

      if you were to have a terrible accident how would you pay the bill? your required to have auto insurance to protect the other guy and for your own well being ..how is this different? should i have to pay your hospital bill if you do not have insurance? this prevents you from losing everything in the event of something bad happening health wise.  this way you do not lose your home, your life’s savings or your parents life savings.

    • http://twitter.com/kgal1298 Kate G

      If I’m that age without healthcare coverage I’m going to quit life. I have freelance friends with insurance they pay out of pocket for and it sucks, but it’s better than nothing. And actually a lot of health care insurance providers will offer incentives for working out. I know people who’ve had their gym memberships covered and visits to the nutritionalist covered. Also, if you work in the public eye you can get extra treatments usually not covered covered by insurance and written off in taxes. You just need to research more on benefits because providers don’t always come out and say it because they don’t want to pay for it. 

  • Rentonsway

    way to rosy as usual   oh yes  ss  will always be funded  oh yea  iraq  will be a quick war  its govt    an  it will bite you in the ass  as  it always does obama  still gets private healthcare but hey he wiped his ass with the constitution  here comes the distraction free hand out look   monkeys shiny shiny   lol .  im sorry but seein obamas performance so far  it  came  from him it will hurt more than help 

    • Respiratorymandl

      can you do better..do u have ideas that will help or do you just bitch

  • 276girl

    it’s so good to know the government can  now tax us for anything “they” think will be good for us. really i always thought i was an adult with the right to make my own decisions. seems like the government likes to take more and grow bigger. i have heard of companies already having to decide to either layoff, don’t expand or cut the insurance all together. oh boy i’m so happy socialism has come to the USA the rest of the world seems to be going in the dumps because of it. the above sure sounds on the good side but why don’t you tell the true cost to all of the people oh yeh how bout that no tax to under 250 thousand income group. right and i have a bridge to sale if you believe that.

    • terrilynnmerritts

      You must have never lived in a real socialist country as I have (several in fact including Canada and in Europe). This pathetic law has nothing to do with socialism. People on Medicare will stay on Medicare. The desperately poor will be on Medicaid. Those who already have an employer based insurance policy will keep it. Those who already have a privately paid insurance policy will keep it. It only means that tens of millions of people who are currently priced out of insurance due to income, work for companies that do not offer insurance, or who have pre-existing conditions that make insurance companies turn them down will be able to buy insurance from a for-profit company (and the death panels they use to keep you and your doctor from making decisions) including help to do so on a sliding scale basis based on income. Socialist countries have a one payer system. In fact this Affordable Care Act was inspired by Romneycare- the law Mittens Romney got passed in Massachusetts which includes a mandate. Seems to be working for people there. This law will create jobs. With so many insured people, there will be a need for more doctors, nurses, nursing aides, physicians’ assistants, physical therapists, medical supply staff, truck drivers, office help and more. 

  • Pink_plaid

    I wish we could all stop being so selfish and actually look at this about the greater good for the nation not just as a financial equation. For all of the people who don’t think they should be paying for someone else I’d like them to consider the armed forces. The average american is so proud of our armed forces and more than happy to allow someone else to serve to “protect their freedom” and to pay takes for the billions we invest in the “national defense”. Imagine if freedom of speech or the vote only applied to those who had served. This nation has always been based on supporting one another, and yes when everyone pays it is cheaper for everyone. With so many re-emerging health risks in this country I should hope that you would be happy to pay towards keeping us all healthy, keeping infectious disease down and allowing more people to be reintegrated into the workforce. As for the statement that people from other countries have to come here for help that statement is only slightly true. We will continue to lead the world in advances because it is financially beneficial to us and having more people with health coverage will actually improve drug development and medical advances. It will also cut down on medical tourism where americans go to Canada, Latin America and many Asian countries for cut rate medical procedures and medication because it’s actually less expensive to travel there and be treated than to be treated than to do it here. For anyone who is diametrically opposed to this bill I honestly have two bits of advice: 1. Educate yourself more on how medicine in the US really works 2. Get over yourself

    • rk

      I think that I am fairly familiar with how medicine works in this country.  First, the medical system is broken.  My practice has a mix of public and private patients and believe you me, we make nothing on the public patients.  Which wouldn’t be terrible except for the fact that I am burdened with astronomical school loans that other doctors from socialized medical countries do not have as they receive their medical training almost for free.  Don’t believe me?  Educate yourself.  Ireland has free university and free medical school.  Doctors there don’t have to make as much as they don’t have crippling debt to service.

      Also,  you need to consider the fact that although this is a rich country, we are going broke.  Our debts are well over three times GNP.  We are borrowing to pay for things like this new medical coverage.  Our infrastructure is crumbling.  We don’t manufacture much here anymore.  We have our major ivy league universities educating a ton of people from other countries and then we tell those highly educated people to leave (no long term visa) yet we allow immigration, particularly to those that were somehow able to find their way here illegally.  

      I would not be surprised if in a few more years the United States finds itself in a similar position to Greece.  We have counties declaring bankruptcy — see Stockton, California and Jefferson County Alabama — and cutting services.To this we are adding to our already, and I think you would agree, broken medical system people — many with pre-existing conditions which means they are going to require more care than the average person.   Which will, unfortunately, require money.

      I would love not to consider the financials and simply believe that all will be well.  However, I want to ensure my future so therefore I prefer to look at the situation realistically. 

    • er

      “Get over yourself”? This is not about people getting over themselves, it is about a country that is making big decisions that affect everyone! I don’t appreciate you telling others to get over themselves as you have no idea what people spend their money and time on! I am sure that American’s as a whole do not give enough to their churches or charities, but that is part of the freedom we should have with our money! I work for a charity, and for the majority, all of our clients are supported by the working people of America through welfare!  And yes, I do believe that we need to help others, so in some situations disability and temporary unemployment is necessary. But we are paralyzing people on welfare, as they get used to not working for the money they receive and then their children learn the same habits! WELFARE IS NOT A CAREER!!!

    • er

      “Get over yourself”? This is not about people getting over themselves, it is about a country that is making big decisions that affect everyone! I don’t appreciate you telling others to get over themselves as you have no idea what people spend their money and time on! I am sure that American’s as a whole do not give enough to their churches or charities, but that is part of the freedom we should have with our money! I work for a charity, and for the majority, all of our clients are supported by the working people of America through welfare!  And yes, I do believe that we need to help others, so in some situations disability and temporary unemployment is necessary. But we are paralyzing people on welfare, as they get used to not working for the money they receive and then their children learn the same habits! WELFARE IS NOT A CAREER!!!

  • Nobody

    Do not think it will work well because without fixing prices on procedure for private practise vs instutition (inc) doctors and hospitals it will destroy private practises. In the long run it will cause a doctor shortage and insurance companies will benifit the most. It takes money away from doctors and gives it to insurance companies which are state regulated cause separte and not equal health care depending on where you live and how you make.

  • Nidavigurl

    Just wait until your ‘forced’ rates go up, WAY up, like what’s happened in other countries. And wait until your coverage goes down, WAY down. There’s a reason millions of Canadians who already have this forced healthcare are forced to come to the USA to pay out of pocket for their cancer surgeries, severe health issues, as their ‘forced’ insurance still won’t cover them. CURRENTLY: We each pay high amounts as is for required insurance.The insurance chooses not to cover for many things though they have trillions in money from each person. For those that don’t have insurance including billions of illegal aliens that we keep pardoning, hospital still bills them, and seeks money from the government. We still also pay not only our own insurance now, but we pay into Medicaid twice (yes, twice) to cover everyone else that doesn’t have insurance. Government has plenty of money from the taxpayers, and workers still pay into their insurance a ton. The problem is that the insurance companies are not covering people though they are paying. Insurance companies are not doing what they say they are going to do. Medical costs themselves are getting too high. So instead of fixing the reasons behind the high medical costs, and instead of fixing the insurance companies not covering people who pay in at least a couple thousand a year, instead the government forces, yes, forces, every single person to pay for insurance or by 2016 have a tax/fee of nearly $700 (so they say.) OH!! PLUS you will still have to pay Medicaid (twice with the Medicaid II ) If you don’t pay, you go to jail/prison depending on how far you are behind. You already pay for insurance at work? Well guess what, just like with other places and yes, Massechussetts, they will take all the insurance providers and replace them with their own insurance providers. The rates will increase severly and you of course are forced to pay them and won’t be able to afford them (unless you are rich). It will look good at first, but then the insurance companies still won’t cover your procedures and won’t be required to. You will pay more, still not get healthcare coverage. If your job is like most of Amercia’s, you are already barely making enough to get by and still paying a ton into insurance as is, and Medicaid and Medicaid II. So when the new insurance raises their rates, you won’t be able to afford things like rent, food, you know the things that the government feels doesn’t matter. State assistance? No, you won’t qualify as they only use gross income, not income after any insurance or anything. If you lose your insurance, get denied insurance or your work messes up your insurance, well that sucks for you, have fun paying those fees or going to jail. They are about to take a whole bunch of innocent people, just trying to get by, and turn them into felons. unless you are rich. 

    • pamorama

      Complete rhetoric and doomsdaying. As if our rates aren’t going WAY up as it is. As if most of us aren’t paying triple what we did a decade ago. Millions of Canadians are coming here?!?! That is news to any of the Canadians I know. They feel sorry for Americans. Oh the rhetoric you have regurgitated.

    • Shelley

      I hear so much about these Canadians – still haven’t seen one in a doctor’s office!  

  • http://twitter.com/booglesclash booglesclash

    Thanks for this article! It really highlights the impact that the act will have on all of us. I am glad that this has passed into law. I pay roughly $400 for health insurance for just myself a month. I also have a pre-existing condition that keeps me from shopping around. My husband is paying for my private insurance while I look for a job (I’m in between jobs at the moment) that will allow me to have more affordable coverage. I’m looking forward to the pre-existing clause going into effect!

    I have heard the common complaint about the 1% tax on those that will not be getting insurance and do not qualify for government subsidies. Some equate this 1% tax as the government forcing them to do something. Are we not charged taxes on our everyday purchases and homes? Further, some states require that individuals pay an additional state income tax. Is that seen as unconstitutional? I understand that some of you may feel forced into this, but I’ve done the math. A 1% for tax is not much, especially compared to a monthly insurance premium. If 1% of your yearly income is a substantial amount of money, then why aren’t you buying insurance? Accidents happen, unforeseen illnesses and diseases come even to people that try to be healthy. This act has been created to help alleviate the problems that occur when there are too many uninsured people.

    I acknowledge that everyone has the right to their opinion. Nevertheless, for individuals mainly concerned with a 1% tax on yearly income, just consider there are many (such as myself) that wish we could be worried about a 1% tax rather than making sure our premiums are paid. You can choose to opt out of insurance, I (with my pre-existing condition and expensive monthly medication) am not so lucky. There is no choice for people like me.

  • sw1

    -

    Anyone who claims to have lived in Europe where
    socialized medicine is prevalent (and claim it works) obviously has no idea
    what they are talking about. I lived for 3 years in Austria, my best friend is
    from Ireland and another lives in England. If you have ANY, even serious
    illness you cannot see a doctor in a reasonable period of time – in fact you
    may wait 8 months – 12 months – WHY? Because the doctors don’t earn enough.
    What does that mean? That you BUY more private insurance so you can get a
    doctor to see you. The entire health care system wasn’t broke in the U.S. – the
    vast majority of people are covered by their employer or other programs.
    Wouldn’t it have been simpler and more acceptable to most people to have FIXED
    what was broken and not try to socialize this country? Mark my words… if this
    law is allowed to stand, we will see worse care (unless you pay more). What
    needs fixing: tort reform, individuals being allowed to buy under group plans,
    over state line purchasing, etc., etc. AND yes, the uninsured should be covered
    by a catastrophic coverage — far cheaper to those of us who will pay for it
    then what’s going to happen now. Pre-existing conditions? The majority of
    company insurance covers this – I have worked for 30 years and never had any
    employer’s insurance exclude pre-existing conditions, and I don’t believe that
    my coverage was extraordinary. And I laugh out loud to any (including this
    article’s author) who believes this is going to be cheaper. Pricing comes down
    when there is adequate and fair competition. What you will find less doctors
    and caregivers, not more. The people truly in need of care (the young, poor and
    elderly) will be the ones LEAST likely to get care. Those with good insurance,
    etc. (just like today) will get the best care. Wake up and be realistic so we
    can really change health care for the better.

    • http://twitter.com/kgal1298 Kate G

      It wont fix everything, but certain things did have to be passed. Not all insurers would help in pre-existing conditions. This is why my dad couldn’t get covered. Also the ACA is also covering womens birth control and it’s lowered the cost of certain medications. The fact is the ACA isn’t popular, but their are parts of it that needed to be passed because health care in America isn’t that great either. I’ve waiting 6 hours before in an emergency center in the US waiting to be covered. Drs. need to stop scheduling so many patients and take their time diagnosing which is really the cause of bad health care that and they need to be protected from being sued for everything they do, but then again who knows. I lived in Europe for a while as well I was told if I need dental or health to go to Germany…no it’s not great in Europe or Canada, but have you ever not been insured? Because I have and that sucks even worse than when you are insured in America. 

    • pamorama

      How interesting … I was born in Berlin, have oodles of friends that live in Germany, England, France, Australia, and Canada and not ONE of them has ever experienced anything like what you describe. My friends in Germany get such incredible care, and this is substantiated by how many Americans (when they have the wealth to do so) go to Germany for treatment.

      Additionally, one can see by the odd breaks and annoying paragraphing that you have cut and pasted this rather than responded in a thoughtful fashion.

      • CaptainObveeus

        From the standpoint of a Financial Advisor… Politics aside… The idea that premiums will go down under this plan is absurd. The poor will simply pay the tax not to be insured, and those who have been uninsurable due to pre-existing conditions will flood the risk pool. This will force premiums upward to compensate for the risk. The idea that THIS bill was a victory in any way is truly rhetoric in and of itself. There are so many hidden agendas and vague descriptions in this piece of legislation for a reason… Without clearly defined rules, you can make your own. Our Constitution is circumvented repeatedly in this piece of legislation and those loopholes are already being used. Wake up people, this isn’t just about healthcare.

    • Mildly Amused

      I believe it is YOU that does not know what they are talking about!  I won’t waste my time going into each and every misconception you have made, but here is my favorite MISCONCEPTION you have made:
      “Pre-existing conditions? The majority ofcompany insurance covers this “  
      NOT!!!!!!   You couldn’t POSSIBLY be MORE WRONG on this!!!!!!   I know from personal experience!   I do not know of a SINGLE insurance policy from ANY provider prior to ACA that covers ANY pre-existing condition!!!!!!!!!!
      You are full of manure!

    • BigMc

      I have lived in Central / Eastern Europe for fifteen years. I can tell you that anyone I know who wants professional, prompt, modern health care, pays for it out of pocket and skirts the nationalized care completely!  I have friends who have waited YEARS for medical treatment because of horribly long waits.  This is due to several factors – one of which may sound silly to Americans, but doctors here complain all the time of “hobby patients” – under socialized health care you can literally camp out each day at your doc’s doorstep and your doctor MUST receive you!  So, our family doctor said she had at least ten elderly patients a day who came every single day, even though they were healthy, simply because it was free!  

      Free healthcare which requires you to wait years for a simple medical procedure is no health care at all!  Good luck, America.

  • kfmarshall

    wow.  i finally know how to vote this fall:  ROMNEY.  hands down, to make sure this is immediately halted.  

    • Amber

      What makes you think this would be halted with Romney?  This is a replica of the health care plan in MA that he implemented!  Take a look at Ron Paul people.

      • http://www.facebook.com/people/Kim-Johnson/1082313456 Kim Johnson

        I think you need to look at Paul…yes, he wants to legalize pot, but he also wants to get rid of Title IX, ban abortion for all reasons, ban birth control for at least single women(and possibly married women would have to have a note from their husbands, who knows?), he’s anti-gay(although he will take contributions from gay folks, just not use their bathroom), would roll back civil rights and, if you believe his excuse about his racist newsletter, is too stupid to make sure that people don’t write nasty articles and attribute the articles to him! 

    • http://twitter.com/kgal1298 Kate G

      So you’re against womens health care rights? You know the ACA covers womens birth control? You know Romney also was behind the individual mandate in Massachusettes right?

    • Mildly Amused

      REALLY??  Why is that?  You don’t WANT healthcare coverage? Or maybe you don’t want Healthcare costs to be REDUCED??? Please explain.

    • RMP

      Based on your decision to vote Romney, I can only assume that you can afford health insurance unlike more than a majority of Americans, or you are still on your parent’s plan and believe the lies and bullshit that have been spoon fed you by the GOP,   Republicans have voted 31 times to get rid of Obamacare and have done everything in their power to get rid of Planned Parenthood.  This is an extreme example of  big government getting between a woman and her doctor.  If they succeed in getting rid of the new healthcare plan, they will do nothing to reform the broken healthcare system despite their statements to the contrary.  Their #1 goal is to help the wealthy at the expense of the middle class and poor.  They will try to get rid of Social Security, Medicare, student loans and grants, energy conservation and deregulate everything that we have fought for over the years to protect our environment.

      Be careful what you wish for. 

  • Tinasnpr

    This is going from bad to worse.  Again, thousands and thousands of illegal immigrants are going to get a free ride, while Americans are going to have to pay for it…seems to be a trend with Obama.   I think the whole government system is broken and we as a people need to stand up and take charge like our fore fathers did.  Without us they are nothing, They better be listening.    They pay for nothing and make us pay for them forever.  Tired of it….really tired of it.

    • http://www.facebook.com/people/Kim-Johnson/1082313456 Kim Johnson

      Undocumented workers are not allowed coverage under ACA, just like they don’t receive medicaid benefits. If they go to the hospital, they will be treated, but that is usually because its an emergency. In fact, resident aliens and naturalized citizens are not covered until they’ve been in the country for at least 5 years–and Mexico has had health care coverage for their citizens(and visitors) for years! Please, try to know what you’re writing about before doing so, it makes you look much less ignorant.

      • http://twitter.com/kgal1298 Kate G

        That’s what I was saying. Besides that my friends who are illegal pay out right for their care costs. Meaning they pay thousands for medical care when they go and many more just don’t go get help at all except in an emergency. 

    • http://twitter.com/kgal1298 Kate G

      You know what’s hilarious most of the illegals I know in LA do pay taxes and actually do more for the communities than some upper class americans I know. So if you are going to spout something go out and learn some facts first. Yeah some of them do seed off Americans, but I’ve met American’s who seed off people and don’t deserve the free ride either so before you spout what the media has told you why not walk a mile in other shoes. Not to mention I’ve met quite a few mexicans that have moved back to Mexico after living in the US they visit here to see their families that stayed. I just wish the media would get the facts right on immigration not all of them are bad. They are people like you and I and there is the good and the bad, but please just don’t spout out things that you really don’t know the facts too. 

      • pamorama

        Thank you so much, Kate, for being a well-informed, reasonable American. I am so tired of all the unsubstantiated rhetoric, when all one has to do is Google to find information that disputes the far-right xenophobic spin.

    • RMP

      This is an opinion that makes me really sad.  It is ignorance talking.  ”Illegals”  pay into the system  just like all Americans who work for a paycheck.  Moreover, they are willing to do jobs that most Americans would not consider doing and without them, we would be worse off.  
      Why is it that you never see any white people toiling in the fields?  Who do you think picks your fruits and vegetables for your table?   Stop the hateful and ignorant rhetoric now!

  • Guest

    This shows how well it’s worked for MA, imagine for the Nation.
     http://www.boston.com/lifestyle/health/articles/2011/01/03/ballooning_medicaid_costs_strain_bay_state_budget/

  • Sjmva78

    The last paragraph said it all, but also shows how little people think. The states will pay more, but Americans will benefit greatly. Hello, we make up those states, somebody has to pay for it. 

  • slb0422

    The poverty level for a family of 4 is not $92k. That would mean that two parents making $45k each would be considered to be living in “poverty”….I don’t think so. Check your facts please

    • http://twitter.com/andycochran Andy Cochran

      The article says, “four times the federally defined poverty level.”

    • AldenWicker

      Hi slb0422,

      Thanks for your comment. In this case, we’re not saying that the poverty level is $92,200 for a family of four; we’re saying that four times the poverty level for a family of four is $92,200. We’ve updated the post with the clarification.

  • Laura

    I work in insurance and it is a fact that when you spread the risk (which is what insurance is – paying ahead of time against the risk of a substantial claim in the future) across a large segment of the population and don’t get to pick and choose who does and who does not get coverage, the cost per person by and large will go DOWN.  I’m very glad to see an article that points this out accurately.  It’s a “rising tide lifts all ships” kind of principle at work – when it’s not just the old and the sick seeking health care any more, the cost of insuring people will go down.

  • http://twitter.com/FL0WERB0MB Flowerbomb

    People are so desperate to get something “free” from the government that they believe the lies. It’s clear you refuse to listen to anything anyone says who does not agree with you. I can only hope that those who support Obamacare and vote for Obama end up paying the price for that decision, and you will. Take care of yourselves because Obamacare won’t take care of you.

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  • MARTIN BOSLER

    I AM REQUIRED TO PURCHASE A NEW CAR AS WE WERE HIT AND TOTTALD OUR CAR.  WE HAVE INSURANCE ALREADY AND WILL CONTINUE ON SAME THANK YOU

  • Snoman

    This is a hit piece.  Wish I never read it.  

  • guest

    I want to know what is going to happen to people that work for a company that offers high deductable  insurance at the cost of 932.00 a month that  covers NOTHING, and pays out nothing until a yearly deductable of 2,500.00 on top for the MONTHLY 932.00 IS MET. that comes out to 13,683.00 a year OUT OF MY POCKET BEFORE INS PAYS.. I DONT EVEN USE THAT KIND OF MONEY  A YR TO SEE THE DOC! We cant afford  to pay ( IF WE WANT TO PAY OUR LIVING EXPENCES) that so we decline this “insurance”
    i JUST READ AN ARTICLE  ON YAHOO THAT SAID IN 2014 THE GOVENMENT  has told companies that they will have to enroll ALL their employees in the insurance they offer..What are we suppose to do when we cant afford to live and this insurance is basically staying in the insurance companies pockets?? I want insurance AND i AM WILLING TO PAY but not 13,683.00 to get nothing! To expect a person to pay that is utterly  insane! does anyone have the answer or  a place for me to call and get answers.. the stress of this is getting to me

  • Josh

    I wish someone could explain this to me because I’m still lacking knowledge on how this works. For instance, I’m 30, married and no kids and I work two jobs and make a total of about 24,000. My wife makes around 20,000 a year. After all our bills were lucky if we have $100 a month left to buy food. We have a lot of bills. We couldn’t afford Obama Care even if it was 50 dollars a month. To do so means we would have to stop eating. So how does this work for someone like me? I just can’t afford this

  • Sandraharley93

    I like it my employer dont have insurance and im single and cant aford insurance

    • Sandraharley93

      My boyfriend had a stroke 2 years ago and didnt have insurance and the hospital had some program and they paid the bill because he was only 37 and he couldnt get medcaid