It doesn’t matter if you’re interested in politics or couldn’t give a hoot, the decision will directly impact you, your family and your friends for years to come.
Even though the justices are supposed to be ruling only on whether the individual mandate requiring most people to buy health insurance is constitutional, the decision could undermine most — if not all — of the Patient Protection and Affordable Care Act. That’s because only by expanding the base of customers can insurance companies afford the cost of providing coverage to everyone, including people with expensive preexisting conditions.
To put this in perspective, half of all adults ages 55-64 have a preexisting condition. That’s just a fact of aging: Human beings eventually get sick and wear out.
Assuming the law is upheld, the individual mandate doesn’t take effect until Jan. 1, 2014.
(The law is more commonly referred to by the nickname, “ObamaCare,” because President Obama pushed it. The moniker, created by Republicans, is a little ridiculous, however. As one columnist noted, we don’t call Social Security “RooseveltCare” or refer to Medicare and Medicaid as “JohnsonCare.” Maybe the GOP knows the image of a black attorney is far scarier to its voters than a New York aristocrat or a Texas rancher.)
Other key provisions of the law — some of which already are in place — include prohibitions against insurers from placing dollar limits on their customers’ lifetime benefits, preventing insurers from canceling coverage when a customer gets sick and creating a special high-risk insurance pool for people with serious medical conditions.
Also, young adults are allowed to stay on their parents’ plans until age 26, and elderly people will receive a rebate to cover Medicare’s “doughnut hole” and reduce drug costs it doesn’t cover. Small businesses will get tax cuts to help pay for employee coverage.
But without the individual mandate, it’s a good bet that this house of cards will come tumbling down.
A report issued April 2 by the Government Accountability Office (GAO), the federal government’s independent auditor, said if ObamaCare is overturned, the nation’s debt will grow faster than if the law remained untouched.
“Federal deficits and debt have reached historic highs in recent years.
Congress has taken action to address the fiscal imbalance, but longer-term challenges remain,” the GAO’s report states.
“As our 2011 simulations showed, if the Patient Protection and Affordable Care Act (PPACA) is implemented as intended it would have a major effect on the gap but would not eliminate it. The aging of the population and rising health care costs will continue putting upward pressure on spending,” the report continues. “Several provisions of PPACA were designed to control the growth of health care costs. The full implementation and effectiveness of these cost-control provisions, which are reflected in the Baseline Extended simulation, would slow the growth in federal health care spending over the long term.”
Health care spending is growing faster than the overall U.S. economy as more members of the Baby Boom generation become eligible for federal health programs. The number of Baby Boomers turning 65 will jump in coming years. They averaged about 7,600 per day in 2011, and will grow to about 11,400 per day by 2029.
Although the GAO said other measures also are necessary, its report stated that ObamaCare is one component that helps contain costs in coming years.
Spending on Social Security, Medicare, Medicaid and interest would grow to about 70 cents of every dollar spent by 2040, if ObamaCare is kept intact.
By comparison, such spending would account for 73 cents of every federal dollar spent by 2040 if the law is struck down.
“Overall, our simulations illustrate the difficult trade-offs that policymakers will have to consider in order to rebalance the federal government’s fiscal position,” the GAO’s report concludes.
The second anniversary of ObamaCare becoming law was March 23. To mark the occasion, Ohio Consumers for Health Coverage held events in 40 cities and towns across the state to outline the law’s benefits that already have been realized.
Cathy Levine, the group’s co-chairwoman, said the individual mandate only would affect 1 percent of Americans. Eighty-three percent of Americans have health coverage. About 16 percent of the people without coverage would either receive subsidies or be exempted, she added.
“That leaves an estimated 1 percent of the population who don’t want insurance and don’t want to be required to have insurance. They, frankly, are freeloading off the rest of us,” Levine said.
“By requiring everyone to pay their fair share, insurance companies can no longer deny coverage to people who are sick and have been labeled with preexisting conditions. That’s what all the fuss is about with the individual responsibility provision.”
Ohio Consumers for Health Coverage is a consumer advocacy group that seeks to achieve affordable, high quality health-care for all people. Its supporters include labor unions like AFSCME and SEIU, along with groups like the Ohio Council of Churches, the League of Women Voters of Ohio, AARP, the Children’s Defense Fund and others.
Frankly, conservatives should hope that ObamaCare is upheld. If it isn’t, probably the easiest route around the legal arguments made against the individual mandate is to create a robust “public option,” which could be achieved by expanding the current Medicare program.
The public option involves the creation of a government-sponsored insurance plan to compete with private insurance providers. It’s important because it would provide a fallback for people who private companies won’t insure, and use economies of scale to negotiate lower prices from physicians and drug companies, providing an incentive for private plans to do the same and get serious about eliminating waste.
This is something that many progressives, including myself, had hoped all along that Obama would seek. He didn’t because he was trying to compromise and use a private sector strategy that once was embraced by people like Mitt Romney and endorsed by conservative think tanks like the Heritage Foundation.
If that happens, maybe all the fear mongering by the Far Right will have been worth it.