Thursday, June 28, 2012

How Today's ACA Ruling Matters Going Forward

So the Affordable Care Act is here to stay. What's next? Here's what the President said earlier this morning.

And here's what's about to happen in the real world. On one hand, there's some concern about how much regulatory authority the federal government now has. But when one really looks at the meat of the ruling, the Supreme Court essentially reaffirmed the federal government's role in taxing and regulating the marketplace. Ultimately, a majority of Supreme Court Justices rejected the "tea party" argument that expanding health care access to 33 million more Americans is somehow unconstitutional.

And then, there's the practical aspect. We have the 33 million Americans who will finally soon have health care.

The individual mandate, by bringing healthy people into the insurance market and lowering premiums, means health insurance for between 12.5 million and 24 million more Americans than if the mandate was struck down. And as Kennedy said in his dissent that the conservatives on the Court believed the entire law should have been invalidated, it means health insurance for 33 million more Americans than if Kennedy and the conservatives had their way.

Those are big numbers, But behind them are real people. People like Eric Richter.

Richter, a 39-year-old resident of Ohio, works at a stone drilling company. He and his wife made $36,000 a year. That’s too much to qualify for Medicaid, but too little to easily afford insurance. So Richter didn’t purchase insurance. “It’s hard to pay for the unknown, when you’re struggling to cover the known,” he told Sabrina Tavernise of the New York Times. “I know it sounds irresponsible, but that’s just the way it was. It’s a game of roulette you hope you’re going to win.”

Then Richter discovered a tumor growing up his leg. He first tried home remedies, cutting out sugar and eating beets, having read somewhere that it might help. But it kept growing. His wife sewed him new pants to accommodate the “melon-sized” lump. He stood in church, because it was too painful to sit down. He was turned away from a needed scan because he lacked insurance. In April, doctors in the emergency room told Richter his tumor was malignant. His wife desperately tried to find an insurer would would cover them. No one would. The tumor was, of course, a preexisting condition. [...]

The passage of the Affordable Care Act means that, come 2014, people like the Richters get guaranteed health care coverage. If their income is less than 133 percent of the poverty line, they receive Medicaid (unless their state rejects federal Medicaid dollars for the expansion, something the Court made it easier for them to do). If their income is between 133 percent and 400 percent, they receive some level of subsidies. At $36,000, the Richters would be paying less than $200 a month, and no insurer can turn them away. If they are now below the poverty line, they get Medicaid, no questions asked.

And of course, we'll soon see change here in Nevada. As we've discussed before, the Affordable Care Act is already starting to make a real, positive impact on many Nevadans' lives.

In March, Joe Heck introduced a bill to repeal the ACA. It already looks like Dean Heller and several other Republicans are talking about repealing the ACA. Do they really want to go there?

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Certainly, health care will continue to be a major political football this year. But really, do Mitt Romney, Dean Heller, and Joe Heck really want to "re-litigate" health care reform and continue threatening to take health care away from many thousands of Nevadans?

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