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What you need to know about health care now

Published: Fri, June 29, 2012 @ 7:50 a.m.

Staff/wire reports

The Supreme Court upheld the constitutionality of President Barack Obama's health care law Thursday, includi

Download as PDF:
Affordable Care Act Decision

US Supreme Court Document in the case of the National Federation of Independent Business vs. Sebelius, Secretary of Health and Human Services.

ng the most disputed part: the mandate that virtually all Americans have health insurance or pay a fine.

The mandate was upheld under the federal government’s power to levy taxes. Here’s a look at the ruling upholding the Affordable Care Act:

The ruling

The ruling put some limits on the law’s plan to expand the Medicaid insurance program for the poor, a joint effort of the federal government and states.

It says the U.S. government cannot threaten to withhold a state’s entire Medicaid allotment if it doesn’t participate in the expansion.

President Obama said, “I know there will be a lot of discussion today about the politics of all this, about who won and who lost. That’s how these things tend to be viewed here in Washington. But that discussion completely misses the point.

“Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.”


Many parts of the law have proved popular. But the insurance mandate is widely disliked.

Each time AP has asked in polls, more than 8 in 10 Americans have said the government should not have the right to require everyone to buy health insurance.

The public also has tilted against the law as a whole over the two years since it was passed. About half opposed it and a third were in favor in a poll shortly before the Supreme Court ruled.


The Supreme Court decision affects nearly every American. The law tells almost everyone they must have health coverage and guarantees it will be available to them even if they are already ill or need hugely expensive care.

It helps the poor and many middle-class people afford coverage.

“I just don’t believe it’s a good plan,” said Rick Rinko, a retired shipping worker from Girard. “It doesn’t fit in where we are going at all.”

Many college students and young workers approached in the Youngstown area Thursday were not quite sure about the law.

If one thing is for sure, there is an air of uncertainty surrounding the purchasing mandate and what it means for individuals.

“It would be nice to have insurance because I don’t go to the doctor very often,” said Sahad Awad, 25, of Liberty as she sat scrolling through pictures on her smartphone with a group of friends at the Boardman Starbucks. “But I have no idea what it means that, ‘I have to purchase it.’ I can’t. It’ll cost too much.”

As a stipulation of the health care law, beginning in 2010, many of the country’s youths were allowed to stay on their parents plan until they are 26. For Awad, it wasn’t an option. Her “parents simply could not afford it.”

Another of Awad’s friends, Sam Mhawesh, 23, of Boardman, said he also was without insurance.

“I can’t go to the doctor, it costs too much,” he said.

Mhawesh complained of a toothache he’s had for months. He said just to have it examined at a local emergency room cost him $184. Although he currently works, Mhawesh doesn’t know if he’ll be able to afford the insurance required under the mandate, or even what steps he is supposed to take to meet it.


The high court upheld the mandate that virtually all Americans have health insurance or pay a fine. The court said that fine is essentially a tax, and that’s why the government has the power to impose it.

The ruling limited the law’s plan to expand the Medicaid insurance program for the poor, a joint effort of the federal government and states. It says the U.S. government cannot withhold a state’s entire Medicaid allotment if it doesn’t participate in the expansion.

Chief Justice John Roberts sided with the court’s four liberal justices — Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor — to form the 5-4 majority.


Final word from the court amplifies the most polarizing issue of Obama’s re-election campaign against Republican Mitt Romney.

Romney said, “Obamacare was bad law yesterday. It’s bad law today. If we want to get rid of Obamacare, we’re going to have to replace President Obama.”

GOP lawmakers and Romney have promised to repeal the law if they are in power after the November election.

U.S. Rep. Bill Johnson of Marietta, R-6th, and his Democratic challenger, Charlie Wilson of St. Clairsville, who are deadlocked in one of the nation’s most-competitive Congressional races, quickly released statements on the decision.

“This disastrous law is full of broken promises covered in empty political rhetoric that continue to make our economy worse,” Johnson said, adding he will work for repeal of the law.

“Over 40 percent of small businesses are saying that this law is keeping them from hiring and expanding. The cost of this law has surged to almost $2 trillion, and doctors are already limiting the number of patients they are seeing,” he said.

“Here’s the good news for the people of eastern Ohio: The doughnut hole is closed; the costs of prescription drugs are lower, and families can keep children on their parents’ plan until the age of 26,” Wilson said.

Wilson, however, tempered his remarks by adding: “This law is not perfect, and I look forward to working with members of both parties to improve the law by giving states more flexibility to innovate, to hold down costs and to help small businesses spend less on health care and more on creating jobs.”

Ohio’s former Democratic governor said the Republican opponents risk alienating Americans who will benefit from the changes. Ted Strickland, an Obama campaign co-chairman, also called on his Republican successor’s administration to get moving on a state health care exchange under the law.

Gov. John Kasich and Lt. Gov. Mary Taylor issued a statement saying they were analyzing a court ruling they found disappointing and are concerned about dramatically higher costs it could mean in the state for Medicaid and other coverage.

“This matter will now be fought out in the political arena, again,” said Attorney General Mike DeWine, a Republican.


The ruling could force companies to make some tough decisions about how to handle rising health care costs, said Joe Bell, director of corporate communications for the Cafaro Co.

“The act doesn’t do anything about the root cause of rising health care costs. It simply spreads the costs around to constituents and to businesses,” he said.

Now that the decision has been made, businesses simply need to find a way to implement it, manage it and embrace the change, said Thomas Humphries, president and CEO of the Youngstown/Warren Regional Chamber.

There have been some small companies locally that have benefited from the Affordable Care Act, said Paul M. Dutton, a business lawyer at Harrington, Hoppe & Mitchell. The law allows small companies to receive a rebate from the government for continuing health care levels.

“I had one client, a cemetery in the city of Youngstown, that received a check for $23,000 for maintaining the same very good level of insurance,” he said.


The 2010 health care law will keep taking effect. It’s expected to bring coverage to about 30 million uninsured people. Overall, more than 9 in 10 eligible Americans will be covered.

Some parts are already in effect: Young adults can stay on their parents’ insurance up to age 26. Insurers can’t deny coverage to children with health problems.

Limits on how much policies will pay out to each person over a lifetime are eliminated. Hundreds of older people already are saving money through improved Medicare prescription benefits. And co-payments for preventive care for all ages have been eliminated.

“We look forward to providing essential health services for more members of our community as coverage expands; and we are also pleased that expanded coverage will reduce the burden of uncompensated care on our hospital and others across the nation,” said David Fikse, chief executive officer of ValleyCare Health System of Ohio, which includes Northside Medical Center in Youngstown, Trumbull Memorial Hospital in Warren and Hillside Rehabilitation Hospital in Howland.

“Expanded coverage will help to ensure that hospitals are reimbursed for services they provide, making our nation’s health care system stronger for the benefit of everyone,” Fikse added.


Starting in 2014, almost everyone will be required to be insured or pay a fine. There are subsidies to help people who can’t afford coverage. Most employers will face fines if they don’t offer coverage for their workers. Newly created insurance markets will make it easier for individuals and small businesses to buy affordable coverage. And Medicaid will be expanded to cover more low-income people.

Insurers will be prohibited from denying coverage to people with medical problems or charging those people more. They won’t be able to charge women more, either. During the transition to 2014, a special program for people with pre-existing health problems helps these people get coverage.

An assortment of tax increases, health-industry fees and Medicare cuts will help pay for the changes.

The health care overhaul focus will now quickly shift from Washington to state capitals. Only 14 states, plus Washington, D.C., have adopted plans to set up the new health insurance markets called for under the law.

Called exchanges, the new markets are supposed to be up and running Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers.


An estimated 26 million people will remain without coverage once the law is fully implemented, including illegal immigrants, people who don’t sign up and choose to face the fines instead, and those who can’t afford it even with the subsidies. That number could be higher, depending on whether any states refuse the Medicaid expansion.


In 2016, after the law is fully in place, about 4 million people will pay the penalty to the Internal Revenue Service for being uninsured, the Congressional Budget Office has estimated.

They would pay $695 per uninsured adult or 2.5 percent of family income, up to $12,500 per year.

The IRS can’t prosecute violators or place liens against them, however. Its only enforcement option may be withholding money from refunds.


1Woody(492 comments)posted 4 years ago

Umm...Vindy...read the ruling...it is no longer a fine or penalty...it is a tax. And a tax that will hit people making less than $150k a year. Another broken promise of the broken Obama presidency.

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2Ytownnative(1121 comments)posted 4 years ago

What alot don;t understand it doesnt matter if you can afford it or not It is a mandatory tax. If you have to choose between paying the tax and eating,car payment, house note, car insurance, etc.... the tax still has to be paid whether you go do the doctors or not

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3IslandMike(764 comments)posted 4 years ago

ROMNEYCARE made HC more affordable in Massachusetts, lowered the states deficit and created jobs. That's HIS platform. Now he's saying that OBAMACARE, the same exact piece of legislation but with a different name is a job killer that's going to drive up the price of care and add to the deficit? Sounds like Mitt-Flopper will say anything to get elected.

The Affordable Care Act was modeled after ROMNEYCARE.

-Thanks Mitt!!!

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4Freeatlast(1991 comments)posted 4 years ago

TEACARE John Roberts is Bush/GOP/TEA party guy
He made it the law of the land not Obama .

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56675409(37 comments)posted 4 years ago

The chants of four more years were giving them all a warm glow as they were pitching their tents as squatters in the brownfields. It is good to have choices but the $1,500. yearly fine will lessen them. Paying the family doctor , medication, food or housing. These are choices that those in government and setting the rules don't have to make. Who are we to be vindictive and deny them just because they deny us?



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6SunnySkies(20 comments)posted 4 years ago

Okay, before I can weigh in on this ( as well the Supreme Court should have insisited before voting) can they please exactly identify what "Affordable" is in dollars and cents?? Is it $200 per person a month? $500 per person a month? $750 a month for a couple? $900 a month for a couple and two children? And since it is for ALL AMERICANS may I now drop my $1200 a month health insurance ( with a $2000 deductible) and switch over and get the exact same care & benefits? "Affordable healthcare for all Americans" Why not just regulate the health insurance companies?

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7redvert(2239 comments)posted 4 years ago

Do we really think that those that have been on the dole for generations are going to pay a fine for not having healthcare. The fine will just be added to their freebee benefits and then subtracted so it will not be a issue..... maybe not for them but it will be for those of us that will end up paying for it. By the way, that will be hard working DEMOCRATS along with REPUBLICANS so enjoy your victory dummies!!!

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8Jerry(858 comments)posted 4 years ago

I saw a comment this morning from an Obamacare supporter who voiced approval for the Obamacare legislation; but went on to fret about how she was not sure she could depend on it and if it were not “too good to be true” because some later president or Congress could take it away. This was, of course, intended as a slap at the Republicans & conservatives who are vowing to repeal Obamacare. I’m sure the pro-Obamacare writer did not realize it or intend it, but she actually hit the nail on the head for a major argument against Obamacare……….WHAT THE GOVERNMENT GIVETH, THE GOVERNMENT CAN TAKETH AWAY.

Here is the difference between the sides, however:

The conservatives on the right vowing to repeal Obamacare will taketh it away, but they will do so while there are still many other private sector healthcare options for Americans to choose from. We can then work to address the long list of problems affecting out healthcare system with individual targeted fixes, rather than one impossibly huge over-reaching power grab.

On the other hand, the progressive left pushing for Obamacare want to enact and enforce this monstrosity so that all private sector options are eventually killed off, leaving us all at the mercy of one single government controlled healthcare system. What will we do then, when the government decides to taketh away healthcare, when there are no other options?? If they decide broccoli is good for us and everyone should buy broccoli (or get taxed more for their healthcare); then I guess we will all buy broccoli. Oh…..and by the way….. the broccoli will probably have to be purchased from members of an agricultural group that just happens to be a major contributor to the DNC.

I can also structure the argument another way to get different attention. Let’s suppose we do continue down this road and fully enact the principles of government controlled healthcare. Let’s further suppose that at some point in the future (4 years, 8 years, 16 years) an ultra-religious conservative president is elected. He/she could use the power of the government healthcare bureaucracy to eliminate the availability of abortions and raise the healthcare tax on coverage for contraception. He/she could raise the healthcare taxation for pregnancy and child care for children born out of wedlock. He/she could point to statistics that indicate people who attend a church live longer and healthier lives, and therefore insist Americans who do not attend a church should face higher healthcare taxation. This is the power we are now granting to the government.

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9bumbob(146 comments)posted 4 years ago

Everyone needs to focus and do some research on the content of the law. I know it's huge but you can do it.

First off, the mandate, the very, very misunderstood individual mandate. What needs to be understood right off the bat is that there are exemptions that allow you to go without insurance and avoid the tax penalty. Some of the ways you can be exempt from the mandate include the following:

-If the monthly premium exceeds what you can afford. This is known as the "hard-times exemption." The reason that it exists is for the obvious reason that the government does not expect people to run out and buy insurance if they cannot afford it, even after all the amenities provided by this new law such as subsidies and the expansion of Medicaid.

- If your religion prohibits you from taking part in any sort of government-related program then you do not need to acquire insurance. The Amish religion would be an example of this, I suppose, and the purpose of this exemption is to provide those of certain sectarian beliefs a way to not violate their religious ideology.

-Other obvious kinds of exemptions, i.e. you are imprisoned, not mentally fit to make decisions for yourself- and various others.

Link to help with understanding the mandate: http://bit.ly/QDFAan

The government was not going to pass a law that people would be financially incapable of paying. That would be counter-intuitive.

There's so much misinformation going on about this law right now that it can be stifling to even modestly ponder. So what I offer you is to take a look at the law for yourself (there's a reconciliation bill and manager's amendment to go with it, as well) if you really want to know it's content.

The following link will take you there: http://www.opencongress.org/bill/111-...

Please don't be terrified of this law, Ohio. It is intended to help you and has not even been fully implemented yet. Also, do not listen to the melodramatically terrified businessmen featured in this column since they clearly have not researched the law at all.

It should be the job of the government and media (including The Vindicator) to help disseminate the information contained in this law, but until that actually happens I am happy to help.

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10JimiJam(3 comments)posted 4 years ago

Psssst, Vindy...your conservative lean is showing....

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11Jerry(858 comments)posted 4 years ago

Re: bumbob & the otherside

……”don't be terrified of this law”……Are you kidding?! This law is 2700 pages or the worst legalistic mumbo-jumbo imaginable. It says everything and nothing all at the same time, and was written this way deliberately so it could be interpreted to mean anything. The people who voted for it didn’t read it and still don’t understand it.

Why is it that a Congress from a prior era was able to enact the Homestead Act (the most important piece of legislation of the 19th century that paved the way for the US to become a super-power nation) written in plain English and presented on two pages; yet today new laws are thousands of pages that nobody can read or understand????

The Obamacare law gives authority to a huge undefined federal bureaucracy that will have the power to control our behavior on anything, from broccoli to church attendance, by enacting “penalties’, or “healthcare fees”, or “taxes”, or whatever they want to call them today. The Congress has abdicated their responsibility in this matter, and the Supreme Court has just said it’s OK.

Look around at what is already happening. The EPA is deciding what businesses will be allowed to remain in operation, and which ones will be driven out of business. The NLRB is deciding where the businesses that remain will be allowed to conduct business and who they get to hire; and who they will not hire and where they will not conduct business. The DOJ is deciding what laws will be enforced, and what laws will not; in addition to deciding which laws will be selectively enforced for which people. The legislators elected by the people (Congress) no longer control any of this because they have abdicated their power and responsibility to the federal bureaucrats.

And now, you think it will be a good idea to turn over control of our healthcare too.

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