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The degree of ignorance being expressed here is monumental. For this I largely blame President Obama for not effectively explaining the act. But I have to also admit that there were risks in doing so before the Supreme Court had its say, which they inevitably had to decide.
Currently thee are about 50 million people in the US without health insurance. The Health act as passed by Congress, only provides for coverage of 30 million of those uninsured.
The act states that those who, based upon their their income, can afford buying insurance, must buy it or be penalized.
Why is this? Because the Insurance industry will have the incentive to meet the other requirements the act places upon them due to the millions of new healthy customers they will get because of the mandate. Those buying insurance can select varying coverage and cost plans from insurance exchanges. The main reason the plan does not go into full effect until 2014, is to provide the time to create these exchange networks.
Those who can not afford to buy insurance will receive financial help from the government, and the 17 million poorest citizens would be added to Medicaid, a state run program mostly paid for by US government grants to the states.
The Supreme Court made one change and most people do not yet understand its consequences. They ruled that State Medicaid programs can not be forced to include the additional poor uninsured people in their states, and so will not be eligible for the additional federal subsidies involved. This is a major weakening because the court ruled that Washington could not penalize a state by taking away the money they already received for Medicare. Because of this some part of that 17 million neediest Americans will not get the coverage they were intended to get under the new law. But many states will have a hard time explaining to voters why they are turning down tens of millions of federal dollars to keep their citizens unprotected.
Today about 80% of Americans get health insurance from their employer, most also have to pay a percentage of the cost, and their insurance usually ends or becomes their financial responsibility under the Cobra Act.
Thousand are stuck in jobs they hate in order to preserve their insurance. How did this happen? During WW2, employers had a hard time finding employees because millions of men were in the military for the duration, and competition for workers was intense. Many companies added a perk of health care insurance to attract workers.
Many companies will continue to have health insurance plans to retain their experienced work force, but workers can also have the freedom under the new law to change jobs without the fear of leaving their families without health care, and employer paid health care will be cheaper, because under the new law insurance companies can not deny insurance for pre existing conditions, or charge a higher rate for those with health problems than they charge healthy people.
I am old enough to remember some of the Republican objections to the Social Security Act. They used the same kind of arguments being used today to stop social security, they failed. Then they tried for decades to repeal Social Security, They failed. Today any attempt to take away Social Security is political suicide.
Universal Health Care in this country has been a long time coming. It was first proposed by President Theodore Roosevelt in 1913, and nearly Every Democratic president since Franklin Roosevelt has tried to establish universal Health care. Finally Barak Obama has succeeded, and that alone will earn him a favored place in history. There is still much to be done to improve it, but at least we now have something we can perfect to the benefit of all Americans. In future years any attempt to take it away will be political suicide.
I never had any doubt the Supreme Court would uphold the health care act, I expected a 6 to 3 decision, and I am still surprised that Justice Kennedy did not join the majority, but I knew that Chief Justice Roberts had to find a way to support it. Just as I knew that Justices Scalia, Thomas, and Alito would vote against it.
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