House Minority Leader Nancy Pelosi watches the breaking news from the Supreme Court which upheld the Affordable …The Supreme Court upheld the Affordable Care Act -- also known as "Obamacare" -- in its entirety on Thursday, preserving access to health care for millions of people who would otherwise be turned away because of preexisting conditions or forced to pay higher premiums based on gender.
"No illness or accident should lead to any family's financial ruin," President Barack Obama said after the ruling was announced.
Related: A look at the health care law in all 50 states
Others were dismayed by the decision, pointing out that it amounts to a tax increase on the middle class and insisting that it would raise health care costs for everyone.
"This bill was sold to the American people on a deception," Senate Republican Leader Mitch McConnell said after the ruling was announced. "But it's not just that the promises about this law weren't kept. It's that it's made the problems it was meant to solve even worse."
Given that most of the major provisions of the law haven't yet gone into effect (they're slated for 2014), it's difficult to tell whether Republican fears about runaway costs and higher premiums will pan out. But current provisions will remain in place -- and so far, more than 86 million people have benefited from the law, many of them women and children. For instance:
- Women will no longer be subject to higher insurance rates simply because they're female.
- Pregnancy, depression, having had a Cesarian section, and other issues will no longer be considered "pre-existing conditions" that disqualify women from getting private health insurance.
- Children will continue to be able to stay on their parents' health insurance plans until they are 26 years old, regardless of income level or marital status.
- Insurance companies cannot impose a limit on the amount of coverage a patient can receive during her lifetime.
- Children will no longer be dropped from insurance plans because of pre-existing conditions.
- Women enrolled in new insurance plans no longer need a referral from their primary care physician in order to visit the OB/GYN of their choice.
- Certain types of preventive care will no longer require an out-of-pocket payment. That includes well-baby care, prenatal care, many cancer screenings, blood pressure testing, diabetes testing, cholesterol testing, childhood vaccines and flu shots for kids and adults alike.
- Other types of women-specific preventive care -- including breastfeeding support, domestic violence counseling, FDA-approved contraceptive methods, mammograms, HIV and STD screening and counseling, and well-woman doctor's visits -- will also be covered without a co-payment.
- According to the Obama administration, more than 13 million people will be receiving rebates from their health insurance companies this summer, to compensate for the companies having spent too much on administrative costs.
- Prescription drug savings will continue for those on Medicare.
In 2014, states will be required to set up their own health insurance exchanges so that uninsured individual will be able to access group coverage and Medicaid will be expanded to include more than 16 million low-income people, which means that approximately 30 million currently uninsured people will have health coverage. Insurance companies will no longer be able to limit how much they pay to cover a patient during a single year, and the controversial individual mandate -- upheld by the Supreme Court justices as a tax rather than as a command to purchase insurance -- will go into effect, requiring citizens to pay an additional tax of $95 per year or up to 1 percent of their income (whichever is greater) if they choose not to have health insurance.
"If an individual does not maintain health insurance, the only consequence is that he must make an additional payment to the IRS when he pays his taxes," Chief Justice John Roberts wrote in his ruling. He added that this means "the mandate is not a legal command to buy insurance. Rather, it makes going without insurance just another thing the Government taxes, like buying gasoline or earning an income."
Though there are some concerns that insurance companies will change plans or that employers will drop coverage and steer their workers toward the state-operated exchanges, earlier this month UnitedHealthcare, the nation's largest health care provider, announced that they would continue to offer several major benefits that are part of the Affordable Care Act, regardless of how Supreme Court ruled.
"The protections we are voluntarily extending are good for people's health, promote broader access to quality care and contribute to helping control rising health care costs," Stephen J. Hemsley, president and chief executive of UnitedHealth Group, said in a statement. "These provisions are compatible with our mission and continue our operating practices."
Still, most Tea Party Conservatives and Republicans, including presidential nominee Mitt Romney, vowed on Thursday to repeal the law, pointing out that the majority of Americans feel that it's unconstitutional.
"What the Court did not do on its last day in session, I will do on my first day if elected President of the United States. And that is I will act to repeal Obamacare," he said.
But, as if acknowledging that even Americans who oppose the Affordable Care Act are actually in favor of some of its biggest provisions, Romney also promised to protect people with pre-existing conditions and "do our very best to help each state in their effort to assure that every American has access to affordable healthcare."
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