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Imperium Watch: The Affordable Care Act and You

More and more Americans are benefiting from the law the Supreme Court didn't strike down.

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Thursday, July 12, 2012

The Supreme Court has ruled that the massive health care law known as the Affordable Care Act—in the vernacular, Obamacare—is not unconstitutional. The ruling doesn't leave the law invulnerable, but it undercuts the Right's most reasonable grounds for repealing it.

Immediately after the decision was announced June 28, it was ironic to hear presidential hopeful Mitt Romney decry the ACA as "bad law and bad policy" when the program it establishes is so nearly identical to the one Romney himself established in Massachusetts. Romney's vow to repeal the law was inevitable, and would be laughable if money—the money needed to continue implementing the law—were no object.

How would you like to be the politician to tell people that, thanks to you, insurance companies can go back to their old practices of excluding children with preexisting conditions from coverage; notifying people with chronic conditions like multiple sclerosis that they've reached the limits of their lifetime coverage and can die without further treatment; and bumping young people off their parents' policies at 24 instead of 26, the age set by the ACA?

A less well publicized feature of the law is the Pre-existing Condition Insurance Plan, a sliding-scale program already in effect for adults with preexisting conditions who have been uninsured for six months or more. (The PCIP anticipates an ACA provision that will take effect in 2014, when insurance companies will no longer be able to refuse anyone coverage because of a preexisting condition.) In a widely circulated Web post last winter, Spike Dolomite Ward, a Los Angeles resident who was diagnosed with breast cancer after she and her husband lost their insurance because of high premiums and shrinking business revenue, explained how she got treatment through the PCIP. The day after the Supreme Court's decision on the ACA, Ward updated her story.

"A week ago, I had a double mastectomy after five months of chemotherapy," she told the Los Angeles Times. "I have been receiving outstanding care... no death panels, no rationing, no waiting, no government officials telling my doctors what to do, no denials of tests or treatments, none of the stuff that the plan's critics said would happen."

How would you like to be the politician to tell people like Ward that, thanks to you, the program that covered their treatment for a life-threatening illness was being terminated?

As Robert Scheer pointed out last week on the Truth Dig blog, "... there is no way [Romney] will persuade even a Republican-dominated Congress to get rid of the obviously popular requirements of the new law, now declared constitutional. While the mandatory aspect—pay for insurance or pay a fine—remains unpopular, not so the programs that expand medical coverage to the uninsured. Three-quarters of those polled by The Associated Press said they wanted Congress, instead of sticking with the status quo, to come up with a new plan if the court threw this one out. ...

"If Romney now dares to oppose the popular items in the bill, such as requirements for the insurance companies to cover young adult children or people with pre-existing medical conditions, he is finished as a candidate before he begins."

The law is in danger of losing its intended effect, however, because upcoming budget cuts may make it difficult to implement. To preserve the benefits it provides, people need to let their representatives in Congress know clearly that they want its provisions to remain in force (Massachusetts Sen. Scott Brown, for example, has promised to support a movement by his fellow Republicans to repeal the law).

The greatest danger to continued implementation of the law is that people will not defend it because they do not understand that it is the source of a benefit they or their family members may be receiving. People need to know that if they have a 24-year-old child and they want to keep that child covered under their insurance next year when he/she is 25, they'd better tell their Congresspeople they don't want the ACA repealed outright or undermined for financial reasons.

They need to know that if they or unemployed family members are getting coverage under the Pre-existing Condition Insurance Plan, they could be left high and dry if the law doesn't remain in effect. They need to know that if they have a child with a congenital illness or handicap, they may be unable to get coverage for the child if the law doesn't remain in effect. For more information about what the law does, check www.healthcare.gov.

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