Many Americans have already benefitted from some provisions
– such as young adults under age 26 being permitted to remain on their parents’ health plan, and preventive care now provided for millions of children that were previously unable to get these services. On Monday, the U.S. Supreme Court
begins hearing arguments on whether the individual mandate requirement is constitutional.
This is a key -- and the most contentious -- feature of the ACA. It requires everyone to obtain some form of health insurance, whether through an employer, an group exchange, or through the government – or pay a fine. Subsidies are available for those that cannot otherwise afford coverage.
The Supreme Court ruling will most likely make or break many of the law’s remaining features – such as ensuring no one can be denied coverage due to pre-existing conditions and making insurance more affordable for many through insurance pools. Although most Republicans continue to trash “Obamacare,” Bloomberg News reports that one-quarter of all Americans
benefitted from some kind of preventive service under the law last year – from receiving a simple flu shot to getting free or low-cost mammograms and colonoscopies. Experts say that if the individual mandate portion of the law is struck down, many of the cost-saving features built into the ACA will go by the wayside, inevitably driving costs higher.
Perhaps the best thing to come of the health law is a new focus on prevention, and an increased scrutiny of insurance practices – especially soaring premiums and denials of coverage. The ACA is not perfect – no law truly is. However, there’s no denying that millions of people can now get health care that was previously unaffordable — or denied – due to pre-existing conditions or lifetime caps on payments; that there is an increased focus on prevention, rather than just treatment of major chronic conditions like diabetes and heart disease; and that a sea change in the concept of “health care” is occurring – especially compared with the status quo of two years ago. The United States is the only developed nation
that does not offer some type of national health insurance coverage.
Many state officials
argue that the majority of the financial burden of the new law falls on them – particularly through programs like Medicaid. Insurance mandates mean that more people who are eligible for this program will enroll, they argue, and the states bear the entire financial burden. However, supporters of the law
say the cost of new enrollees will be more than offset by cost savings achieved through prevention and other built-in efficiencies.
Much of the fight about the mandate comes down to whether the federal government can tell the states what to do, or how to care for its citizens. Opponents argue that the law places an “undue burden” on states and individuals, and that the federal government has overstepped its bounds. Supporters say there have always been strings attached to entitlement programs like Medicaid and that if the plan is to work, everyone must participate by purchasing insurance or paying a fine.
that the public is pretty evenly split on support for the law. Of course, the issue is front and center in this year’s presidential election – and November’s results may say more about a mandate than anything the Justices decide.