Sick adults can’t be turned down for insurance because of pre-existing conditions or spending limits. Fewer elders will have to skip pills or cut them in half, because they can’t afford crucial medication. Uninsured patients can go to a regular doctor for routine care instead of the emergency room. Women won’t pay more for being women. And young people can stay on their parents’ insurance until they are 26.
These are just a few gains that will benefit millions of everyday people under President Obama’s health reform plan, which was upheld today in a 5-4 decision by the U.S. Supreme Court in one of its most significant cases and a major achievement for the president. Obama is the first president since Theodore Roosevelt to successfully create a national health plan.
Obama’s goal under the 2010 Patient Protection and Affordable Care Act (ACA) is to ensure medical coverage for nearly everyone, including the 50 million uninsured—19 percent of whom are African-Americans.
“No illness or accident should lead to any family’s financial ruin,” President Obama said in a speech after the ruling. "Insurance companies can no longer jack up your premiums without reason,” he added. “They won’t be able to bill you into bankruptcy.”
“This is a huge victory!” exclaimed Eleanor Hinton Hoyt, president and CEO of the Black Women’s Health Imperative, a national organization based in Washington, D.C. “We have to see this as an opportunity to close the disparity gap.”
Compared to other groups, African-Americans typically have lowered access to health care and higher rates of a host of conditions, including obesity, heart disease, diabetes, fibroids, asthma and certain cancers. Hoyt points out that it will now be easier to obtain checkups, mammograms, preventive screenings for diabetes and treatments to help close the disparity gap. She also welcomes the increase in community health centers and improvements in women’s and children’s health, including prenatal care and more support for breastfeeding.
Elsie L. Scott, Ph.D., president and chief executive officer for the Congressional Black Caucus Foundation, also praised the Supreme Court’s decision.
"Over time, the law will close the gap in prescription drug coverage under Medicare, which leads many low- and moderate-income elderly to forego needed medicine until catastrophic coverage goes into effect,” Scott said in a statement.
In extolling the benefits of his plan, Obama pointed out that so far, the Affordable Care Act has saved the elderly $600 each on prescriptions and provided coverage for six million young adults. Nearly 13 million people also will receive rebates from their insurance companies for administrative and other pass-along costs, he said.
A key and controversial component of the health plan is the “individual mandate,” requiring citizens who can afford insurance to maintain basic coverage or pay a penalty. People could keep or obtain insurance through their employers or go through state exchanges being set up to provide subsidized coverage.
“Starting 2014, this law will offer you an array of quality, affordable health plans to choose from,” Obama said. “I’ve asked Congress to help speed up that process.”
The Supreme Court ruled that the government has the taxing authority to mandate health coverage. Alfred Chiplin Jr., managing attorney at the Center for Medicare Advocacy Inc. in Washington, D.C., called this individual responsibility provision “the heart of the law.” It provides an incentive for insurance companies to cover the sickest and poorest patients by gaining a wider pool of healthy people to offset the cost of chronic illness.
The mandate is also intended to reduce overall health-care costs to taxpayers across the board, in addition to preventing insurance companies from excluding people who have reached spending limits or have pre-existing conditions.
“Everyone has to have some level of insurance, or there won’t be a sufficient number of people in the system to make it sustainable,” Chiplin explained. “Further, those who are uninsured and suffer a health incident are a cost on the society as a whole.”
“People who can afford to buy health insurance should take the responsibility to do so,” the president said. “If you can’t afford the premiums, you’ll receive a credit to help you pay for it.” Those who can afford insurance but fail to do so will face a penalty ranging from $95 to $695 a year.
The court also upheld a provision to expand Medicaid to uninsured adults under 65, but lifted the penalty for states that opt out of the expansion. The federal government would cover 100 percent of the Medicaid expansion for the first three years and then at 90 percent. It would also provide tax credits to help small businesses provide health insurance for their employees.
“Whatever the politics, today’s decision was a victory for people all over the county,” Obama said, adding that Americans shouldn’t have to worry about “the cost of getting well.”
From the start, Republicans rallied against the law with 26 states and a number of private parties filing lawsuits, culminating in a record three days of arguments before the U.S. Supreme Court in late March. A few cases on narrower issues are still pending in lower courts. Republican presidential candidate Mitt Romney pledged to dismantle the law from day one if he makes it to the White House. “I will act to repeal Obamacare,” he said.
“While there will no doubt be attempts by many to repeal and or substantially revise the ACA,” Chiplin said, “the clarity that the law is constitutional frees the society as a whole to engage more vigorously in the task of using our creativity and resourcefulness to implement the ACA so that it can improve the health and welfare of all Americans.”
Yanick Rice Lamb teaches journalism at Howard University and is co-founder of Fully-Connected.com.