Health Insurance Executive Is Longtime Backer of Universal Coverage
Uninsured--and Still Against the Health Law
The 4 Health Care Overhaul Questions Before the Supreme Court
Without Individual Mandate, Fewer Californians with Health Insurance
Great Subject for a Graphic Novel: Health Reform
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FM","link":"/"}},"stateofhealth_15599":{"type":"posts","id":"stateofhealth_15599","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"15599","score":null,"sort":[1381421899000]},"guestAuthors":[],"slug":"enroll-by-valentines-day-to-avoid-obamacare-fines-individual-mandate","title":"Enroll by Valentine's Day to Avoid Obamacare Fines","publishDate":1381421899,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_15604\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550.jpg\">\u003cimg class=\"size-large wp-image-15604\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine.\u003c/p>\n\u003cp>We've also heard that there's a grace period -- that in this first year, people have until March 31 get covered before the fine will kick in.\u003c/p>\n\u003cp>But, whoops! It turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15 -- in other words, the day after Valentine's Day -- to avoid the penalty.\u003c/p>\n\u003cp>Here's why: It takes about two weeks to process applications. Insurance takes effect on the first of the month. You need to enroll by Feb. 15, for the insurance to take effect March 1. Insurance on April 1 is too late, and you will pay the fine.\u003c/p>\n\u003cp>The Jackson Hewitt tax preparation company first pointed out the wrinkle with the health care law's least popular requirement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An administration official confirmed it. The official was not authorized to speak publicly and insisted on anonymity. \u003c!--more-->\u003c/p>\n\u003cp>Brian Haile, senior vice president for health policy at Jackson Hewitt, said government agencies initially had different interpretations of the enrollment deadline. The Health and Human Services department, which is taking the lead in implementing the law, kept referring to a March 31 deadline. But the Internal Revenue Service, which handles most of the financial aspects, suggested that the deadline had to be in February.\u003c/p>\n\u003cp>Leave it to the IRS to figure it out.\u003c/p>\n\u003cp>\"There were inconsistencies,\" said Haile, adding it took several inquiries by Jackson Hewitt over the last few weeks to clear up the uncertainty.\u003c/p>\n\u003cp>Starting next year, the law requires virtually all Americans to have insurance or face a tax penalty, triggered after a coverage gap of three months. (That's why Apr. 1 is too late to avoid the fine, if that's the day your insurance starts.) The penalty starts as low as $95 for 2014, but escalates in subsequent years. There are exemptions for financial hardship and other defined circumstances.\u003c/p>\n\u003cp>The purpose of the penalty is to nudge as many people as possible into the insurance pool. That would help keep premiums in check, since the law also forbids insurers from turning away people with health problems.\u003c/p>\n\u003cp>Haile said an earlier enrollment deadline around Valentine's Day may turn out to be a blessing in disguise for the administration, because it creates a natural opportunity to market to young, healthy people, whose premiums are needed to offset medical costs of older generations.\u003c/p>\n\u003cp>\"When thinking about how to attract young people, a Valentine's Day message may be very salient,\" he said.\u003c/p>\n\u003cp>The administration says the deadline is actually Feb. 15, the day after Valentine's Day.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That's close enough that the government might be able to make the pitch work.\u003c/p>\n\n","blocks":[],"excerpt":"When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine. We've also heard that there's a grace period -- that in this first year, people have until March 31 to enroll before the fine will kick in. \r\n\r\nBut, whoops! Turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15","status":"publish","parent":0,"modified":1381443096,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":504},"headData":{"title":"Enroll by Valentine's Day to Avoid Obamacare Fines | KQED","description":"When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine. We've also heard that there's a grace period -- that in this first year, people have until March 31 to enroll before the fine will kick in. \r\n\r\nBut, whoops! Turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Enroll by Valentine's Day to Avoid Obamacare Fines","datePublished":"2013-10-10T16:18:19.000Z","dateModified":"2013-10-10T22:11:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"15599 http://blogs.kqed.org/stateofhealth/?p=15599","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/10/10/enroll-by-valentines-day-to-avoid-obamacare-fines-individual-mandate/","disqusTitle":"Enroll by Valentine's Day to Avoid Obamacare Fines","WpOldSlug":"enroll-by-valentines-day-to-avoid-obamacare-fines","path":"/stateofhealth/15599/enroll-by-valentines-day-to-avoid-obamacare-fines-individual-mandate","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15604\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550.jpg\">\u003cimg class=\"size-large wp-image-15604\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172765550-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>When it comes to Obamacare, the big date we've heard for a long time is Jan. 1, 2014. That's the day the Affordable Care Act takes full effect, requiring most Americans to be covered, or pay a fine.\u003c/p>\n\u003cp>We've also heard that there's a grace period -- that in this first year, people have until March 31 get covered before the fine will kick in.\u003c/p>\n\u003cp>But, whoops! It turns out that Mar. 31 date is wrong, the Obama administration confirmed to the Associated Press on Wednesday. In order to have coverage by March 31, you need to enroll by Feb. 15 -- in other words, the day after Valentine's Day -- to avoid the penalty.\u003c/p>\n\u003cp>Here's why: It takes about two weeks to process applications. Insurance takes effect on the first of the month. You need to enroll by Feb. 15, for the insurance to take effect March 1. Insurance on April 1 is too late, and you will pay the fine.\u003c/p>\n\u003cp>The Jackson Hewitt tax preparation company first pointed out the wrinkle with the health care law's least popular requirement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An administration official confirmed it. The official was not authorized to speak publicly and insisted on anonymity. \u003c!--more-->\u003c/p>\n\u003cp>Brian Haile, senior vice president for health policy at Jackson Hewitt, said government agencies initially had different interpretations of the enrollment deadline. The Health and Human Services department, which is taking the lead in implementing the law, kept referring to a March 31 deadline. But the Internal Revenue Service, which handles most of the financial aspects, suggested that the deadline had to be in February.\u003c/p>\n\u003cp>Leave it to the IRS to figure it out.\u003c/p>\n\u003cp>\"There were inconsistencies,\" said Haile, adding it took several inquiries by Jackson Hewitt over the last few weeks to clear up the uncertainty.\u003c/p>\n\u003cp>Starting next year, the law requires virtually all Americans to have insurance or face a tax penalty, triggered after a coverage gap of three months. (That's why Apr. 1 is too late to avoid the fine, if that's the day your insurance starts.) The penalty starts as low as $95 for 2014, but escalates in subsequent years. There are exemptions for financial hardship and other defined circumstances.\u003c/p>\n\u003cp>The purpose of the penalty is to nudge as many people as possible into the insurance pool. That would help keep premiums in check, since the law also forbids insurers from turning away people with health problems.\u003c/p>\n\u003cp>Haile said an earlier enrollment deadline around Valentine's Day may turn out to be a blessing in disguise for the administration, because it creates a natural opportunity to market to young, healthy people, whose premiums are needed to offset medical costs of older generations.\u003c/p>\n\u003cp>\"When thinking about how to attract young people, a Valentine's Day message may be very salient,\" he said.\u003c/p>\n\u003cp>The administration says the deadline is actually Feb. 15, the day after Valentine's Day.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That's close enough that the government might be able to make the pitch work.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/15599/enroll-by-valentines-day-to-avoid-obamacare-fines-individual-mandate","authors":["237"],"categories":["stateofhealth_15"],"tags":["stateofhealth_119","stateofhealth_461"],"featImg":"stateofhealth_15604","label":"stateofhealth"},"stateofhealth_14691":{"type":"posts","id":"stateofhealth_14691","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"14691","score":null,"sort":[1378231324000]},"guestAuthors":[],"slug":"obamacare-faq-how-will-the-individual-mandate-work","title":"Obamacare FAQ: How Will the Individual Mandate Work?","publishDate":1378231324,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_14711\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM.png\">\u003cimg class=\"size-large wp-image-14711\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM-640x426.png\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/September/03/FAQ-on-individual-insurance-mandate-ACA.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>It's one of the key building blocks of the insurance overhaul: the individual mandate. It requires most people to obtain health insurance or pay a tax penalty.\u003c/p>\n\u003cp>If you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\u003c/p>\n\u003cp>Yet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a \u003ca href=\"http://www.kff.org/health-reform/poll-finding/march-2013-tracking-poll/\" target=\"_blank\">March 2013 Kaiser Family Foundation poll\u003c/a>.\u003c/p>\n\u003cp>Here are some basic questions and answers about mandate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Q. What is the individual mandate?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">“This individual mandate is to keep premiums low for everyone. If you don’t have incentives for everyone to sign up then only the sick people will enroll.\"\u003c/aside>\n\u003cp>A. The individual mandate is a provision of the federal health law (i.e. \"Obamacare\") that requires you, your children and anyone else that you claim as a dependent on your taxes to have health insurance in 2014 or pay a penalty. That coverage can be supplied through your job, public programs such as Medicare or Medicaid, or an individual policy that you purchase. The health law is setting up online health insurance marketplaces, also known as exchanges, to help you shop for plans.\u003c/p>\n\u003cp>\u003cstrong>Q. Who is affected by the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. The mandate is aimed at some of the 57 million people younger than 65 who now do not have insurance. Roughly 7 million of those without insurance live in California.\u003c/p>\n\u003cp>\u003cstrong>Q. Are there any exceptions to the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. Yes, the government has \u003ca href=\"http://healthaffairs.org/blog/2013/06/27/implementing-health-reform-exemptions-from-the-individual-mandate/\" target=\"_blank\">identified exemptions\u003c/a>. Individuals who cannot afford coverage because the cost of premiums exceed 8 percent of their household income or those whose household incomes are below the minimum threshold for filing a tax return are exempt.\u003c!--more-->\u003c/p>\n\u003cp>Other exempt groups include prisoners, Native Americans eligible for care through the Indian Health Care service, immigrants who are in the country illegally, people whose religion objects to having insurance coverage, members of a \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/michelle-andrews-on-health-care-religious-cooperatives.aspx\" target=\"_blank\">health care sharing ministry\u003c/a> and individuals who experience a short coverage gap of less than three consecutive months.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that in 2016, after the major provisions of the health law are implemented, 24 million people will be exempted from the mandate's penalties.\u003c/p>\n\u003cp>\u003cstrong>Q. What happens if I don't get coverage?\u003c/strong>\u003c/p>\n\u003cp>A. If you do not have the minimum level of coverage and do not qualify for an exemption, you must pay a penalty to the IRS at the end of the tax year. The penalty for the first year is up to $95 per adult and $47.50 per child, or 1 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The fine, however, increases over time and in 2016 will be as much as $695 per adult and $347 per child (up to $2,085 for a family) or 2.5 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The amount you owe will be pro-rated to reflect the number of months you were without coverage.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that 6 million people, about 2 percent of the population, will be assessed a penalty in 2016.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I satisfy the mandate and how does the law help me afford insurance?\u003c/strong>\u003c/p>\n\u003cp>A. Again, if you have employer-based health insurance, Medicare or Medicaid (in California, Medi-Cal), you are set.\u003c/p>\n\u003cp>If you are uninsured or thinking about switching plans, you can shop for coverage through the online marketplaces beginning Oct. 1. The Covered California marketplace is scheduled to open at that time.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more about the health law in KQED's guide, \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained\u003c/a>, just for Californians.\u003c/aside>\n\u003cp>The marketplaces will also offer tax subsidies to help reduce the cost of premiums. If your income is less than 400 percent of the federal poverty level ($45,960 for an individual and $94,200 for a family of four in 2013), you likely will qualify for a subsidy.\u003c/p>\n\u003cp>People with incomes up to 250 percent of the federal poverty level ($28,725 for an individual and $58,875 for a family of four in 2013) are also eligible for cost-sharing subsidies. These additional subsidies will substantially reduce the deductibles, copayments, coinsurance and total out-of-pocket spending limits.\u003c/p>\n\u003cp>Although the law takes effect Jan. 1, the initial enrollment period continues through March 31. Since people are exempted for a short coverage gap – less than three months – individuals that obtain coverage before the end of March will be exempt from the payment for that period.\u003c/p>\n\u003cp>\u003cstrong>Q. Why is there a mandate anyway?\u003c/strong>\u003c/p>\n\u003cp>A. The health law was designed to extend insurance to nearly all people, including those who have medical conditions that require expensive care and are often denied coverage today. But to pay for their care, insurance companies need to have a large enrollment of consumers, especially young and healthy people who use fewer services. The mandate was adopted to guarantee a broad base.\u003c/p>\n\u003cp>\u003ca href=\"http://www.americanprogress.org/about/staff/spiro-topher/bio/\" target=\"_blank\">Topher Spiro\u003c/a>, the vice president of health policy at the Center for American Progress, a left-leaning nonprofit that supports the law, says Obamacare will be more effective with the mandate than without it. \"This individual mandate is to keep premiums low for everyone,\" he said, noting that \"if you don’t have incentives for everyone to sign up for coverage then only the sick people will enroll,\" and that drives up premiums.\u003c/p>\n\u003cp>But others suggest the mandate won't be effective because the penalties are set so much lower than the cost of coverage.\u003c/p>\n\u003cp>\"The mandate was an attempt to get around the fact that insurance is going to become a lot more expensive for a lot of people even with the subsidies,\" said \u003ca href=\"http://www.aei.org/scholar/joseph-antos/\" target=\"_blank\">Joseph Antos\u003c/a>, an economist with the conservative American Enterprise Institute. Antos believes the tax penalty for remaining uninsured is too low and questions the government’s ability to identify those who end up not filing taxes. \"I would argue that the individual mandate is largely unenforceable and does not turn out to be this solution to the other problems that raise insurance costs for that particular group of people,\" he added.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I report my coverage or exemptions to the government?\u003c/strong>\u003c/p>\n\u003cp>A. You will not have to report your coverage or exemptions until you file your 2014 income tax return, which won't be due until April 15, 2015. Insurance providers will also be required to help their clients report their health coverage. The Internal Revenue Service says it will put out details later about how the reporting will work.\u003c/p>\n\u003cp>If your income is so low that you do not file a tax return, you are exempt from paying the penalty.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I apply for an exemption?\u003c/strong>\u003c/p>\n\u003cp>If you are seeking an exemption for incarceration, membership in an Indian tribe or health care sharing ministry, you can apply through the health insurance exchanges or make a claim when you file taxes, according to a final rule issued by the U.S. Department of Health and Human Services. If you are claiming economic hardship or a religious exemption, you must get an exemption certificate from the online insurance exchange. If you are claiming that coverage is unaffordable, you are in the United States without proper documentation or have a coverage gap of less than three months, you can make the claim when you file your 2014 taxes in 2015.\u003c/p>\n\u003cp>\u003cstrong>Q. Where did the idea of the mandate originate?\u003c/strong>\u003c/p>\n\u003cp>A. The origins of the individual mandate have been controversial. Many Democrats who support the law suggest it was originally a conservative idea developed in 1989 by the Heritage Foundation's Stuart Butler to counter liberals' efforts to establish a single payer system and impose a mandate on employers to provide insurance. Several years afterward, Republicans used the individual mandate in a bill they offered as an alternative to Bill Clinton's proposal to overhaul health insurance. The mandate also was incorporated as part of the Massachusetts overhaul of health insurance in 2006 under then-Gov. Mitt Romney.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Democrats later adapted the concept and pushed it as part of the congressional debate over the Affordable Care Act, despite President Barack Obama's initial reluctance to embrace it. Whatever their prior views, most conservatives opposed the health law's version of the mandate, and Butler made a\u003ca href=\"http://usatoday30.usatoday.com/news/opinion/forum/story/2012-02-03/health-individual-mandate-reform-heritage/52951140/1\" target=\"_blank\"> spirited argument \u003c/a>that the current mandate is not what he was endorsing years ago.\u003c/p>\n\n","blocks":[],"excerpt":"It's one of the key building blocks of the insurance overhaul: the individual mandate. The mandate requires most people to obtain health insurance or pay a tax penalty.\r\n\r\nIf you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\r\n\r\nYet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a March 2013 Kaiser Family Foundation poll.","status":"publish","parent":0,"modified":1378328408,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1433},"headData":{"title":"Obamacare FAQ: How Will the Individual Mandate Work? | KQED","description":"It's one of the key building blocks of the insurance overhaul: the individual mandate. The mandate requires most people to obtain health insurance or pay a tax penalty.\r\n\r\nIf you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\r\n\r\nYet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a March 2013 Kaiser Family Foundation poll.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Obamacare FAQ: How Will the Individual Mandate Work?","datePublished":"2013-09-03T18:02:04.000Z","dateModified":"2013-09-04T21:00:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"14691 http://blogs.kqed.org/stateofhealth/?p=14691","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/09/03/obamacare-faq-how-will-the-individual-mandate-work/","disqusTitle":"Obamacare FAQ: How Will the Individual Mandate Work?","path":"/stateofhealth/14691/obamacare-faq-how-will-the-individual-mandate-work","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14711\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM.png\">\u003cimg class=\"size-large wp-image-14711\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM-640x426.png\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/September/03/FAQ-on-individual-insurance-mandate-ACA.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>It's one of the key building blocks of the insurance overhaul: the individual mandate. It requires most people to obtain health insurance or pay a tax penalty.\u003c/p>\n\u003cp>If you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\u003c/p>\n\u003cp>Yet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a \u003ca href=\"http://www.kff.org/health-reform/poll-finding/march-2013-tracking-poll/\" target=\"_blank\">March 2013 Kaiser Family Foundation poll\u003c/a>.\u003c/p>\n\u003cp>Here are some basic questions and answers about mandate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Q. What is the individual mandate?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">“This individual mandate is to keep premiums low for everyone. If you don’t have incentives for everyone to sign up then only the sick people will enroll.\"\u003c/aside>\n\u003cp>A. The individual mandate is a provision of the federal health law (i.e. \"Obamacare\") that requires you, your children and anyone else that you claim as a dependent on your taxes to have health insurance in 2014 or pay a penalty. That coverage can be supplied through your job, public programs such as Medicare or Medicaid, or an individual policy that you purchase. The health law is setting up online health insurance marketplaces, also known as exchanges, to help you shop for plans.\u003c/p>\n\u003cp>\u003cstrong>Q. Who is affected by the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. The mandate is aimed at some of the 57 million people younger than 65 who now do not have insurance. Roughly 7 million of those without insurance live in California.\u003c/p>\n\u003cp>\u003cstrong>Q. Are there any exceptions to the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. Yes, the government has \u003ca href=\"http://healthaffairs.org/blog/2013/06/27/implementing-health-reform-exemptions-from-the-individual-mandate/\" target=\"_blank\">identified exemptions\u003c/a>. Individuals who cannot afford coverage because the cost of premiums exceed 8 percent of their household income or those whose household incomes are below the minimum threshold for filing a tax return are exempt.\u003c!--more-->\u003c/p>\n\u003cp>Other exempt groups include prisoners, Native Americans eligible for care through the Indian Health Care service, immigrants who are in the country illegally, people whose religion objects to having insurance coverage, members of a \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/michelle-andrews-on-health-care-religious-cooperatives.aspx\" target=\"_blank\">health care sharing ministry\u003c/a> and individuals who experience a short coverage gap of less than three consecutive months.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that in 2016, after the major provisions of the health law are implemented, 24 million people will be exempted from the mandate's penalties.\u003c/p>\n\u003cp>\u003cstrong>Q. What happens if I don't get coverage?\u003c/strong>\u003c/p>\n\u003cp>A. If you do not have the minimum level of coverage and do not qualify for an exemption, you must pay a penalty to the IRS at the end of the tax year. The penalty for the first year is up to $95 per adult and $47.50 per child, or 1 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The fine, however, increases over time and in 2016 will be as much as $695 per adult and $347 per child (up to $2,085 for a family) or 2.5 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The amount you owe will be pro-rated to reflect the number of months you were without coverage.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that 6 million people, about 2 percent of the population, will be assessed a penalty in 2016.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I satisfy the mandate and how does the law help me afford insurance?\u003c/strong>\u003c/p>\n\u003cp>A. Again, if you have employer-based health insurance, Medicare or Medicaid (in California, Medi-Cal), you are set.\u003c/p>\n\u003cp>If you are uninsured or thinking about switching plans, you can shop for coverage through the online marketplaces beginning Oct. 1. The Covered California marketplace is scheduled to open at that time.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more about the health law in KQED's guide, \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained\u003c/a>, just for Californians.\u003c/aside>\n\u003cp>The marketplaces will also offer tax subsidies to help reduce the cost of premiums. If your income is less than 400 percent of the federal poverty level ($45,960 for an individual and $94,200 for a family of four in 2013), you likely will qualify for a subsidy.\u003c/p>\n\u003cp>People with incomes up to 250 percent of the federal poverty level ($28,725 for an individual and $58,875 for a family of four in 2013) are also eligible for cost-sharing subsidies. These additional subsidies will substantially reduce the deductibles, copayments, coinsurance and total out-of-pocket spending limits.\u003c/p>\n\u003cp>Although the law takes effect Jan. 1, the initial enrollment period continues through March 31. Since people are exempted for a short coverage gap – less than three months – individuals that obtain coverage before the end of March will be exempt from the payment for that period.\u003c/p>\n\u003cp>\u003cstrong>Q. Why is there a mandate anyway?\u003c/strong>\u003c/p>\n\u003cp>A. The health law was designed to extend insurance to nearly all people, including those who have medical conditions that require expensive care and are often denied coverage today. But to pay for their care, insurance companies need to have a large enrollment of consumers, especially young and healthy people who use fewer services. The mandate was adopted to guarantee a broad base.\u003c/p>\n\u003cp>\u003ca href=\"http://www.americanprogress.org/about/staff/spiro-topher/bio/\" target=\"_blank\">Topher Spiro\u003c/a>, the vice president of health policy at the Center for American Progress, a left-leaning nonprofit that supports the law, says Obamacare will be more effective with the mandate than without it. \"This individual mandate is to keep premiums low for everyone,\" he said, noting that \"if you don’t have incentives for everyone to sign up for coverage then only the sick people will enroll,\" and that drives up premiums.\u003c/p>\n\u003cp>But others suggest the mandate won't be effective because the penalties are set so much lower than the cost of coverage.\u003c/p>\n\u003cp>\"The mandate was an attempt to get around the fact that insurance is going to become a lot more expensive for a lot of people even with the subsidies,\" said \u003ca href=\"http://www.aei.org/scholar/joseph-antos/\" target=\"_blank\">Joseph Antos\u003c/a>, an economist with the conservative American Enterprise Institute. Antos believes the tax penalty for remaining uninsured is too low and questions the government’s ability to identify those who end up not filing taxes. \"I would argue that the individual mandate is largely unenforceable and does not turn out to be this solution to the other problems that raise insurance costs for that particular group of people,\" he added.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I report my coverage or exemptions to the government?\u003c/strong>\u003c/p>\n\u003cp>A. You will not have to report your coverage or exemptions until you file your 2014 income tax return, which won't be due until April 15, 2015. Insurance providers will also be required to help their clients report their health coverage. The Internal Revenue Service says it will put out details later about how the reporting will work.\u003c/p>\n\u003cp>If your income is so low that you do not file a tax return, you are exempt from paying the penalty.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I apply for an exemption?\u003c/strong>\u003c/p>\n\u003cp>If you are seeking an exemption for incarceration, membership in an Indian tribe or health care sharing ministry, you can apply through the health insurance exchanges or make a claim when you file taxes, according to a final rule issued by the U.S. Department of Health and Human Services. If you are claiming economic hardship or a religious exemption, you must get an exemption certificate from the online insurance exchange. If you are claiming that coverage is unaffordable, you are in the United States without proper documentation or have a coverage gap of less than three months, you can make the claim when you file your 2014 taxes in 2015.\u003c/p>\n\u003cp>\u003cstrong>Q. Where did the idea of the mandate originate?\u003c/strong>\u003c/p>\n\u003cp>A. The origins of the individual mandate have been controversial. Many Democrats who support the law suggest it was originally a conservative idea developed in 1989 by the Heritage Foundation's Stuart Butler to counter liberals' efforts to establish a single payer system and impose a mandate on employers to provide insurance. Several years afterward, Republicans used the individual mandate in a bill they offered as an alternative to Bill Clinton's proposal to overhaul health insurance. The mandate also was incorporated as part of the Massachusetts overhaul of health insurance in 2006 under then-Gov. Mitt Romney.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Democrats later adapted the concept and pushed it as part of the congressional debate over the Affordable Care Act, despite President Barack Obama's initial reluctance to embrace it. Whatever their prior views, most conservatives opposed the health law's version of the mandate, and Butler made a\u003ca href=\"http://usatoday30.usatoday.com/news/opinion/forum/story/2012-02-03/health-individual-mandate-reform-heritage/52951140/1\" target=\"_blank\"> spirited argument \u003c/a>that the current mandate is not what he was endorsing years ago.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/14691/obamacare-faq-how-will-the-individual-mandate-work","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_119"],"featImg":"stateofhealth_14711","label":"stateofhealth"},"stateofhealth_4387":{"type":"posts","id":"stateofhealth_4387","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"4387","score":null,"sort":[1332888437000]},"guestAuthors":[],"slug":"what-impact-will-the-courts-decision-have-on-california","title":"What Impact Will the Court's Decision Have on California?","publishDate":1332888437,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_4417\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/LongBeachSunset_RonniePittman_Flickr_03272012.jpg\">\u003cimg class=\"size-medium wp-image-4417\" title=\"(Ronnie Pitman: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/LongBeachSunset_RonniePittman_Flickr_03272012-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ronnie Pitman: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Over the last year as the myriad court cases about the federal health care law have made their way to the highest court in the land, California has spent that time moving ahead aggressively in implementing the \u003ca title=\"http://www.healthcare.gov/law/full/\" href=\"http://www.healthcare.gov/law/full/\" target=\"_blank\">Affordable Care Act\u003c/a> (ACA). California was the first state to pass legislation to set up a \u003ca title=\"http://www.healthexchange.ca.gov/Pages/Default.aspx\" href=\"http://www.healthexchange.ca.gov/Pages/Default.aspx\" target=\"_blank\">health insurance exchange\u003c/a>. The state also set up a new high risk pool so people with pre-existing conditions can get health insurance.\u003c/p>\n\u003cp>But what happens if the Supreme Court declares the individual mandate unconstitutional? Or overturns the entire law? What can still go forward in California?\u003c/p>\n\u003cp>The answer depends in part upon whom you ask. But for the most part California -- like all states -- will find it tough to move forward without the backing of the federal law.\u003c!--more-->\u003c/p>\n\u003cp>Let's start with today's question -- is \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/03/27/supreme-court-justices-sharply-question-individual-mandate/\" href=\"http://ww2.kqed.org/stateofhealth/2012/03/27/supreme-court-justices-sharply-question-individual-mandate/\" target=\"_blank\">the individual mandate\u003c/a> constitutional? The purpose of the individual mandate is to get everyone into the health insurance pool, to spread risk. If the Supreme Court overturns the mandate, but leaves the rest of the ACA intact, the big question is: \"Will the health insurance exchange go forward?\" The exchange is a marketplace the state is establishing for individuals and small companies to buy health insurance. This market currently sports higher health insurance premiums because these groups don't have the same purchasing power as large employers, for example. But without a mandate, there are numerous problems.\u003c/p>\n\u003cp>First, one of the ACA's most popular provisions is its requirement that insurance companies can no longer disqualify people with pre-existing conditions. Bill Kramer is Executive Director for National Health Policy at the \u003ca title=\"http://www.pbgh.org/index.php\" href=\"http://www.pbgh.org/index.php\" target=\"_blank\">Pacific Business Group on Health\u003c/a>, a coalition of large employers that is working to improve health care quality and reduce cost. He says if the mandate was overturned, \"a fair number of people would choose not to get coverage, and you'd end up with the sickest people continuing to get coverage. It would be a high cost risk pool in individual markets.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Indeed. In January the UCLA Center for Health Policy Research released a \u003ca title=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" href=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" target=\"_blank\">study [PDF] \u003c/a>that estimated one million fewer Californians would obtain insurance without the individual mandate.\u003c/p>\n\u003cp>\u003ca title=\"http://www.chhs.ca.gov/Documents/SecretaryDooleyBioPDF.pdf\" href=\"http://www.chhs.ca.gov/Documents/SecretaryDooleyBioPDF.pdf\" target=\"_blank\">Diana Dooley\u003c/a> is California's Secretary of Health and Human Services Agency and also serves on the exchange board. She said whether the exchange could operate if the mandate were struck down is a \"question that cannot be answered.\" Still, she sounded cautiously optimistic in an interview. She pointed out that if the rest of the ACA is upheld, the law includes subsidies to help people purchase insurance. \"If there are subsidies,\" she told me, \"if there is a way to make health insurance more affordable for the uninsured and spread the cost more fairly ... we could still have a robust exchange.\" But that's a big \"if.\" It's unclear if the federal government would be able to provide subsidies if the individual mandate is overturned.\u003c/p>\n\u003cp>But one other popular part of the ACA already enacted which would still go forward is children staying on their parents' health plan until age 26. Pre-existing conditions exclusions for children have already been done away with and, presumably, would also go forward.\u003c/p>\n\u003cp>With one exception, every county in California has enacted a \"\u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" href=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" target=\"_blank\">Low Income Health Program\u003c/a>\" (LIHP). This \"Bridge to Reform\" is intended to help the poor who are not eligible for Medi-Cal obtain coverage until 2014 when the ACA goes into effect. At that point, they will be eligible for Medi-Cal coverage through an expansion legislated by the ACA. The Supreme Court hears oral arguments on the expansion tomorrow, which brings us to...\u003c/p>\n\u003cp>\u003cstrong>What if the Supreme Court strikes down the entire law?\u003c/strong>\u003c/p>\n\u003cp>Again, Dooley sounded a bit more optimistic on this front, even though the federal subsidies would go away. \"If we don't have the additional federal funding and the law of the Affordable Care Act, I think it will be a few years before California can get its feet underneath it to go it alone.\" She believes California would ultimately pass its own individual mandate, something attempted in 2007 during under former Governor Arnold Schwarzenegger that ultimately lost by a few votes in the state senate.\u003c/p>\n\u003cp>But Bill Kramer pointed out that all the pieces of the ACA already put into place in California are all intertwined. \"The reality is given the state's fiscal condition,\" he says, \"it's very difficult to put together all the pieces at the state level.\" In addition, while the federal government can run a budget deficit, California cannot. Kramer points out that the Congressional Budget Office found the ACA to be \"budget neutral\" over ten years, but individual years will run deficits. Most states do not have the luxury of spreading spending for a major program over ten years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Meanwhile, tomorrow is the last day of oral arguments before the Supreme Court. The Court's decisions are expected in late June.\u003c/p>\n\n","blocks":[],"excerpt":"Over the last year as the myriad court cases about the federal health care law have made their way to the highest court in the land, California has spent that time moving ahead aggressively in implementing the Affordable Care Act (ACA). California was the first state to pass legislation to set up a health insurance exchange. The state also set up a new high risk pool so people with pre-existing conditions can get health insurance.\r\n\r\nBut what happens if the Supreme Court declares the individual mandate unconstitutional? Or overturns the entire law? What can still go forward in California?","status":"publish","parent":0,"modified":1332955327,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":15,"wordCount":833},"headData":{"title":"What Impact Will the Court's Decision Have on California? | KQED","description":"Over the last year as the myriad court cases about the federal health care law have made their way to the highest court in the land, California has spent that time moving ahead aggressively in implementing the Affordable Care Act (ACA). California was the first state to pass legislation to set up a health insurance exchange. The state also set up a new high risk pool so people with pre-existing conditions can get health insurance.\r\n\r\nBut what happens if the Supreme Court declares the individual mandate unconstitutional? Or overturns the entire law? What can still go forward in California?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What Impact Will the Court's Decision Have on California?","datePublished":"2012-03-27T22:47:17.000Z","dateModified":"2012-03-28T17:22:07.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"4387 http://blogs.kqed.org/stateofhealth/?p=4387","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/27/what-impact-will-the-courts-decision-have-on-california/","disqusTitle":"What Impact Will the Court's Decision Have on California?","path":"/stateofhealth/4387/what-impact-will-the-courts-decision-have-on-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_4417\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/LongBeachSunset_RonniePittman_Flickr_03272012.jpg\">\u003cimg class=\"size-medium wp-image-4417\" title=\"(Ronnie Pitman: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/LongBeachSunset_RonniePittman_Flickr_03272012-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ronnie Pitman: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Over the last year as the myriad court cases about the federal health care law have made their way to the highest court in the land, California has spent that time moving ahead aggressively in implementing the \u003ca title=\"http://www.healthcare.gov/law/full/\" href=\"http://www.healthcare.gov/law/full/\" target=\"_blank\">Affordable Care Act\u003c/a> (ACA). California was the first state to pass legislation to set up a \u003ca title=\"http://www.healthexchange.ca.gov/Pages/Default.aspx\" href=\"http://www.healthexchange.ca.gov/Pages/Default.aspx\" target=\"_blank\">health insurance exchange\u003c/a>. The state also set up a new high risk pool so people with pre-existing conditions can get health insurance.\u003c/p>\n\u003cp>But what happens if the Supreme Court declares the individual mandate unconstitutional? Or overturns the entire law? What can still go forward in California?\u003c/p>\n\u003cp>The answer depends in part upon whom you ask. But for the most part California -- like all states -- will find it tough to move forward without the backing of the federal law.\u003c!--more-->\u003c/p>\n\u003cp>Let's start with today's question -- is \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/03/27/supreme-court-justices-sharply-question-individual-mandate/\" href=\"http://ww2.kqed.org/stateofhealth/2012/03/27/supreme-court-justices-sharply-question-individual-mandate/\" target=\"_blank\">the individual mandate\u003c/a> constitutional? The purpose of the individual mandate is to get everyone into the health insurance pool, to spread risk. If the Supreme Court overturns the mandate, but leaves the rest of the ACA intact, the big question is: \"Will the health insurance exchange go forward?\" The exchange is a marketplace the state is establishing for individuals and small companies to buy health insurance. This market currently sports higher health insurance premiums because these groups don't have the same purchasing power as large employers, for example. But without a mandate, there are numerous problems.\u003c/p>\n\u003cp>First, one of the ACA's most popular provisions is its requirement that insurance companies can no longer disqualify people with pre-existing conditions. Bill Kramer is Executive Director for National Health Policy at the \u003ca title=\"http://www.pbgh.org/index.php\" href=\"http://www.pbgh.org/index.php\" target=\"_blank\">Pacific Business Group on Health\u003c/a>, a coalition of large employers that is working to improve health care quality and reduce cost. He says if the mandate was overturned, \"a fair number of people would choose not to get coverage, and you'd end up with the sickest people continuing to get coverage. It would be a high cost risk pool in individual markets.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Indeed. In January the UCLA Center for Health Policy Research released a \u003ca title=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" href=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" target=\"_blank\">study [PDF] \u003c/a>that estimated one million fewer Californians would obtain insurance without the individual mandate.\u003c/p>\n\u003cp>\u003ca title=\"http://www.chhs.ca.gov/Documents/SecretaryDooleyBioPDF.pdf\" href=\"http://www.chhs.ca.gov/Documents/SecretaryDooleyBioPDF.pdf\" target=\"_blank\">Diana Dooley\u003c/a> is California's Secretary of Health and Human Services Agency and also serves on the exchange board. She said whether the exchange could operate if the mandate were struck down is a \"question that cannot be answered.\" Still, she sounded cautiously optimistic in an interview. She pointed out that if the rest of the ACA is upheld, the law includes subsidies to help people purchase insurance. \"If there are subsidies,\" she told me, \"if there is a way to make health insurance more affordable for the uninsured and spread the cost more fairly ... we could still have a robust exchange.\" But that's a big \"if.\" It's unclear if the federal government would be able to provide subsidies if the individual mandate is overturned.\u003c/p>\n\u003cp>But one other popular part of the ACA already enacted which would still go forward is children staying on their parents' health plan until age 26. Pre-existing conditions exclusions for children have already been done away with and, presumably, would also go forward.\u003c/p>\n\u003cp>With one exception, every county in California has enacted a \"\u003ca title=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" href=\"http://www.dhcs.ca.gov/provgovpart/Pages/lihp.aspx\" target=\"_blank\">Low Income Health Program\u003c/a>\" (LIHP). This \"Bridge to Reform\" is intended to help the poor who are not eligible for Medi-Cal obtain coverage until 2014 when the ACA goes into effect. At that point, they will be eligible for Medi-Cal coverage through an expansion legislated by the ACA. The Supreme Court hears oral arguments on the expansion tomorrow, which brings us to...\u003c/p>\n\u003cp>\u003cstrong>What if the Supreme Court strikes down the entire law?\u003c/strong>\u003c/p>\n\u003cp>Again, Dooley sounded a bit more optimistic on this front, even though the federal subsidies would go away. \"If we don't have the additional federal funding and the law of the Affordable Care Act, I think it will be a few years before California can get its feet underneath it to go it alone.\" She believes California would ultimately pass its own individual mandate, something attempted in 2007 during under former Governor Arnold Schwarzenegger that ultimately lost by a few votes in the state senate.\u003c/p>\n\u003cp>But Bill Kramer pointed out that all the pieces of the ACA already put into place in California are all intertwined. \"The reality is given the state's fiscal condition,\" he says, \"it's very difficult to put together all the pieces at the state level.\" In addition, while the federal government can run a budget deficit, California cannot. Kramer points out that the Congressional Budget Office found the ACA to be \"budget neutral\" over ten years, but individual years will run deficits. Most states do not have the luxury of spreading spending for a major program over ten years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Meanwhile, tomorrow is the last day of oral arguments before the Supreme Court. The Court's decisions are expected in late June.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/4387/what-impact-will-the-courts-decision-have-on-california","authors":["240"],"categories":["stateofhealth_15","stateofhealth_1"],"tags":["stateofhealth_222","stateofhealth_119"],"featImg":"stateofhealth_4417","label":"stateofhealth"},"stateofhealth_4352":{"type":"posts","id":"stateofhealth_4352","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"4352","score":null,"sort":[1332868098000]},"guestAuthors":[],"slug":"supreme-court-justices-sharply-question-individual-mandate","title":"Supreme Court Justices Sharply Question Individual Mandate","publishDate":1332868098,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>By: KQED News Staff and wires\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4353\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourt_RobertsPic_CourtesySupremeCourt_03272012.jpg\">\u003cimg class=\"size-medium wp-image-4353\" title=\"Chief Justice John Roberts is emerging as a potential swing vote. (Courtesy: U.S. Supreme Court)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourt_RobertsPic_CourtesySupremeCourt_03272012-300x262.jpg\" alt=\"Chief Justice John Roberts is emerging as a potential swing vote. (Courtesy: U.S. Supreme Court)\" width=\"300\" height=\"262\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chief Justice John Roberts is emerging as a potential swing vote regarding the individual mandate. (Courtesy: U.S. Supreme Court)\u003c/figcaption>\u003c/figure>\n\u003cp>Sharp questioning by the Supreme Court's conservative justices has cast serious doubt on the survival of the individual insurance requirement at the heart of President Barack Obama's historic health care overhaul.\u003c/p>\n\u003cp>Arguments at the high court Tuesday focused on whether the insurance requirement \"is a step beyond what our cases allow,\" in the words of Justice Anthony Kennedy.\u003c/p>\n\u003cp>He and Chief Justice John Roberts are emerging as the seemingly pivotal votes.\u003c/p>\n\u003cp>Justices Antonin Scalia and Samuel Alito appeared likely to join with Justice Clarence Thomas to vote to strike down the key provision. The four Democratic appointees seemed ready to vote to uphold it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The individual mandate requires those not covered by employer-based health insurance, Medicare or Medicaid to purchase coverage, with the help of government subsidies if they meet a certain income threshold.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>NPR's \"Shots\" blog also\u003ca title=\"http://www.npr.org/blogs/health/2012/03/26/149417437/high-court-justices-appear-split-on-insurance-mandate?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2012/03/26/149417437/high-court-justices-appear-split-on-insurance-mandate?ps=sh_sthdl\" target=\"_blank\"> reports\u003c/a> that the individual mandate appears to be in trouble.\u003c/p>\n\u003cblockquote>\u003cp>Those challenging the law say the federal government is going way too far with the mandate. This, they say, is the first time the government is making people buy a commercial product they may not want. That's a huge overreach, they contend.\u003c/p>\n\u003cp>Just take a look at the very start of the \u003ca href=\"http://www.kaiserhealthnews.org/~/media/Files/2012/11398bsStatesMinimumCoverageProvision.pdf\">brief\u003c/a> filed by \u003ca href=\"http://www.npr.org/2012/03/23/149218361/the-legal-wunderkind-challenging-the-health-law\">Paul Clement\u003c/a>, the legal wunderkind who is leading the challenge by 26 states to the overhaul law:\u003c/p>\n\u003cp>\"The individual mandate rests on a claim of federal power that is both unprecedented and unbounded: the power to compel individuals to engage in commerce in order more effectively to regulate commerce. This asserted power does not exist.\"\u003c/p>\n\u003cp>After Clement finished his arguments along those lines, SCOTUSblog's Tom Goldstein left the courtroom \u003ca href=\"http://www.scotusblog.com/2012/03/audio-update-from-tom/\">to file an update saying\u003c/a>, \"The individual mandate is in trouble — significant trouble. It's too early to tell whether it will be struck down.\"\u003c/p>\n\u003cp>Still, it's clear that the court's conservative justices are \"quite skeptical.\" And Goldstein said, \"Paul Clement gave the best argument of any kind that I've ever heard.\"\u003c/p>\u003c/blockquote>\n\u003cdiv>\u003c/div>\n\n","blocks":[],"excerpt":"Sharp questioning by the Supreme Court's conservative justices has cast serious doubt on the survival of the individual insurance requirement at the heart of President Barack Obama's historic health care overhaul.\r\n\r\nArguments at the high court Tuesday focused on whether the insurance requirement \"is a step beyond what our cases allow,\" in the words of Justice Anthony Kennedy.\r\n\r\nHe and Chief Justice John Roberts are emerging as the seemingly pivotal votes.","status":"publish","parent":0,"modified":1332883291,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":366},"headData":{"title":"Supreme Court Justices Sharply Question Individual Mandate | KQED","description":"Sharp questioning by the Supreme Court's conservative justices has cast serious doubt on the survival of the individual insurance requirement at the heart of President Barack Obama's historic health care overhaul.\r\n\r\nArguments at the high court Tuesday focused on whether the insurance requirement "is a step beyond what our cases allow," in the words of Justice Anthony Kennedy.\r\n\r\nHe and Chief Justice John Roberts are emerging as the seemingly pivotal votes.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Supreme Court Justices Sharply Question Individual Mandate","datePublished":"2012-03-27T17:08:18.000Z","dateModified":"2012-03-27T21:21:31.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"4352 http://blogs.kqed.org/stateofhealth/?p=4352","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/27/supreme-court-justices-sharply-question-individual-mandate/","disqusTitle":"Supreme Court Justices Sharply Question Individual Mandate","path":"/stateofhealth/4352/supreme-court-justices-sharply-question-individual-mandate","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By: KQED News Staff and wires\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4353\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourt_RobertsPic_CourtesySupremeCourt_03272012.jpg\">\u003cimg class=\"size-medium wp-image-4353\" title=\"Chief Justice John Roberts is emerging as a potential swing vote. (Courtesy: U.S. Supreme Court)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourt_RobertsPic_CourtesySupremeCourt_03272012-300x262.jpg\" alt=\"Chief Justice John Roberts is emerging as a potential swing vote. (Courtesy: U.S. Supreme Court)\" width=\"300\" height=\"262\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Chief Justice John Roberts is emerging as a potential swing vote regarding the individual mandate. (Courtesy: U.S. Supreme Court)\u003c/figcaption>\u003c/figure>\n\u003cp>Sharp questioning by the Supreme Court's conservative justices has cast serious doubt on the survival of the individual insurance requirement at the heart of President Barack Obama's historic health care overhaul.\u003c/p>\n\u003cp>Arguments at the high court Tuesday focused on whether the insurance requirement \"is a step beyond what our cases allow,\" in the words of Justice Anthony Kennedy.\u003c/p>\n\u003cp>He and Chief Justice John Roberts are emerging as the seemingly pivotal votes.\u003c/p>\n\u003cp>Justices Antonin Scalia and Samuel Alito appeared likely to join with Justice Clarence Thomas to vote to strike down the key provision. The four Democratic appointees seemed ready to vote to uphold it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The individual mandate requires those not covered by employer-based health insurance, Medicare or Medicaid to purchase coverage, with the help of government subsidies if they meet a certain income threshold.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>NPR's \"Shots\" blog also\u003ca title=\"http://www.npr.org/blogs/health/2012/03/26/149417437/high-court-justices-appear-split-on-insurance-mandate?ps=sh_sthdl\" href=\"http://www.npr.org/blogs/health/2012/03/26/149417437/high-court-justices-appear-split-on-insurance-mandate?ps=sh_sthdl\" target=\"_blank\"> reports\u003c/a> that the individual mandate appears to be in trouble.\u003c/p>\n\u003cblockquote>\u003cp>Those challenging the law say the federal government is going way too far with the mandate. This, they say, is the first time the government is making people buy a commercial product they may not want. That's a huge overreach, they contend.\u003c/p>\n\u003cp>Just take a look at the very start of the \u003ca href=\"http://www.kaiserhealthnews.org/~/media/Files/2012/11398bsStatesMinimumCoverageProvision.pdf\">brief\u003c/a> filed by \u003ca href=\"http://www.npr.org/2012/03/23/149218361/the-legal-wunderkind-challenging-the-health-law\">Paul Clement\u003c/a>, the legal wunderkind who is leading the challenge by 26 states to the overhaul law:\u003c/p>\n\u003cp>\"The individual mandate rests on a claim of federal power that is both unprecedented and unbounded: the power to compel individuals to engage in commerce in order more effectively to regulate commerce. This asserted power does not exist.\"\u003c/p>\n\u003cp>After Clement finished his arguments along those lines, SCOTUSblog's Tom Goldstein left the courtroom \u003ca href=\"http://www.scotusblog.com/2012/03/audio-update-from-tom/\">to file an update saying\u003c/a>, \"The individual mandate is in trouble — significant trouble. It's too early to tell whether it will be struck down.\"\u003c/p>\n\u003cp>Still, it's clear that the court's conservative justices are \"quite skeptical.\" And Goldstein said, \"Paul Clement gave the best argument of any kind that I've ever heard.\"\u003c/p>\u003c/blockquote>\n\u003cdiv>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/4352/supreme-court-justices-sharply-question-individual-mandate","authors":["240"],"categories":["stateofhealth_15","stateofhealth_1"],"tags":["stateofhealth_222","stateofhealth_119"],"featImg":"stateofhealth_4378","label":"stateofhealth"},"stateofhealth_4291":{"type":"posts","id":"stateofhealth_4291","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"4291","score":null,"sort":[1332807014000]},"guestAuthors":[],"slug":"blue-shield-ceo-is-longtime-backer-of-universal-coverage","title":"Health Insurance Executive Is Longtime Backer of Universal Coverage","publishDate":1332807014,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_4301\" class=\"wp-caption alignleft\" style=\"max-width: 272px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield.jpg\">\u003cimg class=\"size-medium wp-image-4301 \" title=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield-300x330.jpg\" alt=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" width=\"272\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bruce Bodaken is CEO of Blue Shield of California. (Photo: Cindy Charles)\u003c/figcaption>\u003c/figure>\n\u003cp>To those who haven't followed the health care debate closely until now, you might be surprised by one of California's leading proponents of universal coverage. It's \u003ca title=\"https://www.blueshieldca.com/bsca/about-blue-shield/corporate/leadership/ceo.sp\" href=\"https://www.blueshieldca.com/bsca/about-blue-shield/corporate/leadership/ceo.sp\" target=\"_blank\">Bruce Bodaken\u003c/a>, CEO of Blue Shield of California, one of California's largest health insurance companies. He first proposed a system of universal coverage for Californians ten years ago.\u003c/p>\n\u003cp>\"At that time, there was 20 percent of Californians without coverage,\" he said in an interview with KQED. \"We looked at that in one of the richest societies in the world and said, 'Simply unacceptable for people not to have at least basic health care.' So we proposed that all people in California have at least basic coverage. Those that can't afford it would be subsidized and all groups and individuals would be mandated to be covered.\"\u003c/p>\n\u003cp>It sounds a lot like the \u003ca title=\"http://www.healthcare.gov/law/full/index.html\" href=\"http://www.healthcare.gov/law/full/index.html\" target=\"_blank\">Affordable Care Act\u003c/a> (ACA) being considered by the Supreme Court this week. Tomorrow, the Court will hear oral arguments about the constitutionality of the individual mandate -- the requirement that all Americans have health insurance. Those opposed say that Congress has exceeded its authority in requiring Americans to purchase a product.\u003c!--more-->\u003c/p>\n\u003cp>Bodaken doesn't see it that way. \"I'm no lawyer and the Court will decide whatever they decide,\" he says. \"But I do know this -- we mandate many things in this society. ... I have to send my children to school, at least to a certain age. If you want to drive a car, you have to have auto insurance. I don't think this is all that different.\"\u003c/p>\n\u003cp>Tuesday, lawyers arguing in favor of the individual mandate are expected to make what -- at first glance -- looks like an odd request. They will ask the Court that if Justices decide to strike down the individual mandate, that they also strike down a very popular provision of the ACA, the \"guaranteed issue\" provision. You might know it as the requirement that insurers accept everyone, regardless of pre-existing medical conditions. Bodaken understands why the Obama Administration would ask the Court to strike down guaranteed issue if it declares the individual mandate unconstitutional.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"If we don't have everyone in, those that need care and those that don't need care,\" Bodaken says. \"There are not enough premium dollars going into the pool to make it affordable for everyone.\" Bodaken went on to give a hypothetical example: he's a runner and asked what could happen if he needed a knee replacement. If there were no mandate to be insured, he could remain uninsured until the last minute.\u003c/p>\n\u003cp>\"Then I would go in, have coverage for a couple months, have surgery that might cost $30-50,000, and then drop coverage. Obviously, that doesn't work.\"\u003c/p>\n\u003cp>Blue Shield of California, like other health insurers, has come under fire for rising premiums. Bodaken could not precisely predict prices, because the exact benefits under the ACA have not yet been set. But he does anticipate more affordable coverage if everyone in California has health insurance. \"The increases over the last few years to a great extent is that the market has gotten smaller with the recession. ... Only the people that are the sickest stay in and everyone else drops off.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In some ways, is it such a surprise that a health insurance executive would support a government mandate that would bring his company more customers? \"Our concern was not whether or not we would get additional enrollees,\" Bodaken countered. \"We will get our fair share and that's great. What's really important -- whether Blue Shield gets one more enrollee or none -- is that people in California, indeed in the United States, have access to good care, at least in terms of the basics of health care.\"\u003c/p>\n\n","blocks":[],"excerpt":"To those who haven't followed the health care debate closely until now, you might be surprised by one of California's leading proponents of universal coverage. It's Bruce Bodaken, CEO of Blue Shield, one of California's largest health insurance companies. He first proposed a system of universal coverage for Californians ten years ago.\r\n\r\n\"At that time, there was 20 percent of Californians without coverage,\" he said in an interview. \"We looked at that in one of the richest societies in the world and said, 'Simply unacceptable for people not to have at least basic health care.' So we proposed that all people in California have at least basic coverage. Those that can't afford it would be subsidized and all groups and individuals would be mandated to be covered.\"","status":"publish","parent":0,"modified":1332862036,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":640},"headData":{"title":"Health Insurance Executive Is Longtime Backer of Universal Coverage | KQED","description":"To those who haven't followed the health care debate closely until now, you might be surprised by one of California's leading proponents of universal coverage. It's Bruce Bodaken, CEO of Blue Shield, one of California's largest health insurance companies. He first proposed a system of universal coverage for Californians ten years ago.\r\n\r\n"At that time, there was 20 percent of Californians without coverage," he said in an interview. "We looked at that in one of the richest societies in the world and said, 'Simply unacceptable for people not to have at least basic health care.' So we proposed that all people in California have at least basic coverage. Those that can't afford it would be subsidized and all groups and individuals would be mandated to be covered."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Health Insurance Executive Is Longtime Backer of Universal Coverage","datePublished":"2012-03-27T00:10:14.000Z","dateModified":"2012-03-27T15:27:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"4291 http://blogs.kqed.org/stateofhealth/?p=4291","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/26/blue-shield-ceo-is-longtime-backer-of-universal-coverage/","disqusTitle":"Health Insurance Executive Is Longtime Backer of Universal Coverage","path":"/stateofhealth/4291/blue-shield-ceo-is-longtime-backer-of-universal-coverage","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_4301\" class=\"wp-caption alignleft\" style=\"max-width: 272px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield.jpg\">\u003cimg class=\"size-medium wp-image-4301 \" title=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/BruceBodakenHeadShot_03262012_COurtesy_BlueShield-300x330.jpg\" alt=\"Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)\" width=\"272\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bruce Bodaken is CEO of Blue Shield of California. (Photo: Cindy Charles)\u003c/figcaption>\u003c/figure>\n\u003cp>To those who haven't followed the health care debate closely until now, you might be surprised by one of California's leading proponents of universal coverage. It's \u003ca title=\"https://www.blueshieldca.com/bsca/about-blue-shield/corporate/leadership/ceo.sp\" href=\"https://www.blueshieldca.com/bsca/about-blue-shield/corporate/leadership/ceo.sp\" target=\"_blank\">Bruce Bodaken\u003c/a>, CEO of Blue Shield of California, one of California's largest health insurance companies. He first proposed a system of universal coverage for Californians ten years ago.\u003c/p>\n\u003cp>\"At that time, there was 20 percent of Californians without coverage,\" he said in an interview with KQED. \"We looked at that in one of the richest societies in the world and said, 'Simply unacceptable for people not to have at least basic health care.' So we proposed that all people in California have at least basic coverage. Those that can't afford it would be subsidized and all groups and individuals would be mandated to be covered.\"\u003c/p>\n\u003cp>It sounds a lot like the \u003ca title=\"http://www.healthcare.gov/law/full/index.html\" href=\"http://www.healthcare.gov/law/full/index.html\" target=\"_blank\">Affordable Care Act\u003c/a> (ACA) being considered by the Supreme Court this week. Tomorrow, the Court will hear oral arguments about the constitutionality of the individual mandate -- the requirement that all Americans have health insurance. Those opposed say that Congress has exceeded its authority in requiring Americans to purchase a product.\u003c!--more-->\u003c/p>\n\u003cp>Bodaken doesn't see it that way. \"I'm no lawyer and the Court will decide whatever they decide,\" he says. \"But I do know this -- we mandate many things in this society. ... I have to send my children to school, at least to a certain age. If you want to drive a car, you have to have auto insurance. I don't think this is all that different.\"\u003c/p>\n\u003cp>Tuesday, lawyers arguing in favor of the individual mandate are expected to make what -- at first glance -- looks like an odd request. They will ask the Court that if Justices decide to strike down the individual mandate, that they also strike down a very popular provision of the ACA, the \"guaranteed issue\" provision. You might know it as the requirement that insurers accept everyone, regardless of pre-existing medical conditions. Bodaken understands why the Obama Administration would ask the Court to strike down guaranteed issue if it declares the individual mandate unconstitutional.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If we don't have everyone in, those that need care and those that don't need care,\" Bodaken says. \"There are not enough premium dollars going into the pool to make it affordable for everyone.\" Bodaken went on to give a hypothetical example: he's a runner and asked what could happen if he needed a knee replacement. If there were no mandate to be insured, he could remain uninsured until the last minute.\u003c/p>\n\u003cp>\"Then I would go in, have coverage for a couple months, have surgery that might cost $30-50,000, and then drop coverage. Obviously, that doesn't work.\"\u003c/p>\n\u003cp>Blue Shield of California, like other health insurers, has come under fire for rising premiums. Bodaken could not precisely predict prices, because the exact benefits under the ACA have not yet been set. But he does anticipate more affordable coverage if everyone in California has health insurance. \"The increases over the last few years to a great extent is that the market has gotten smaller with the recession. ... Only the people that are the sickest stay in and everyone else drops off.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In some ways, is it such a surprise that a health insurance executive would support a government mandate that would bring his company more customers? \"Our concern was not whether or not we would get additional enrollees,\" Bodaken countered. \"We will get our fair share and that's great. What's really important -- whether Blue Shield gets one more enrollee or none -- is that people in California, indeed in the United States, have access to good care, at least in terms of the basics of health care.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/4291/blue-shield-ceo-is-longtime-backer-of-universal-coverage","authors":["240"],"categories":["stateofhealth_15","stateofhealth_1"],"tags":["stateofhealth_228","stateofhealth_222","stateofhealth_119"],"featImg":"stateofhealth_4301","label":"stateofhealth"},"stateofhealth_4060":{"type":"posts","id":"stateofhealth_4060","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"4060","score":null,"sort":[1332526061000]},"guestAuthors":[],"slug":"uninsured-and-still-against-the-health-law","title":"Uninsured--and Still Against the Health Law","publishDate":1332526061,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_4081\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/UninsuredVarney1.jpg\">\u003cimg class=\"size-medium wp-image-4081\" title=\"Libertarian Paul Ruffino, 55, has been looking for an insurance plan since leaving his previous job. Several insurance companies refuse to cover him because he has pre-existing conditions\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/UninsuredVarney1-300x169.jpg\" alt=\"Libertarian Paul Ruffino, 55, has been looking for an insurance plan since leaving his previous job. Several insurance companies refuse to cover him because he has pre-existing conditions. \" width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Libertarian Paul Ruffino, 55, has been looking for an insurance plan since leaving his previous job. Several insurance companies refuse to cover him because he has pre-existing conditions. (Photo: Sarah Varney)\u003c/figcaption>\u003c/figure>\n\u003cp>Today marks the second anniversary of the federal health care law, and, unless you've been depriving yourself of news for the last several weeks, that same law will be front and center before the Supreme Court starting Monday. Here in California, uninsured Californians have a particular stake in the Court's actions.\u003c/p>\n\u003cp>Madera County is a largely conservative and agricultural area where one in every three people lacks coverage. While many people say they want the Supreme Court to throw out the federal health law, I found that many there are struggling to reconcile their political views with the basic need for health insurance.\u003c/p>\n\u003cp>I started off in Oakhurst. Here, just a few miles from the entrance to Yosemite National Park, is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama’s signature initiative, including people like Joe Stern. \"ObamaCare is absolutely horrible, horrible, horrible. It should struck down immediately.\"\u003c!--more-->\u003c/p>\n\u003cp>Stern sips on a glass of pinot noir. He’s 66 years old, a registered Republican and owns a small water conditioning company. He is covered by Medicare, and he says he’s thankful for the program. Before he turned 65, Stern paid mightily for his health insurance.\u003c/p>\n\u003cp>\"I, a single person, was paying $670 a month,\" he told me. \"I thought it was pretty brutal but I was still against ObamaCare by far, ‘cause I saw how they did it in the middle of the night. It was just totally, it’s not how you do a radical change like that. You do it slowly.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If at all. Like many conservative voters I interviewed in Madera County, Stern despises the individual mandate included in the law, the requirement that all Americans have health coverage.\u003c/p>\n\u003cp>There is a lot of suspicion here about whether the health insurance system is really all that broken. Stern thinks many people choose to be uninsured, and in a sentiment I heard from nearly everyone I interviewed, Stern says no one is denied medical care.\u003c/p>\n\u003cp>\"I don’t know of anyone that was left on the street to bleed to death,\" he says. \"I don’t know anyone that is really left out.\"\u003c/p>\n\u003cp>I asked Stern if he knew anyone at the bar who is uninsured. He turned cheerfully to his friend Mary Westover sitting next to him. Westover was coy about her age. She’s maybe 50-ish. She’s a registered Republican and self-employed artist and businesswoman. She’s been uninsured for 17 years.\u003c/p>\n\u003cp>\"When I was married I had insurance through my husband. Since we got divorced, I was self employed. I just couldn’t afford it. I couldn’t afford the premiums. I was flying by the seat of my pants every inch of the way,\" Westover said.\u003c/p>\n\u003cp>It’s been nearly two decades since Westover has had a pap smear or a mammogram. She says she just tries to take care of herself. She’s opposed to the individual mandate but says she wasn’t aware the federal government would give subsidies to people like her to buy a policy.\u003c/p>\n\u003cp>\"If it were subsidized, if it were made, you know, manageable, I would want that,\" Westover told me. \"And I don’t know how people who can afford it, can sit there and say that we shouldn’t have that. Because there are a lot more of us, than them.\"\u003c/p>\n\u003cp>The ranks of the uninsured in Oakhurst, like everywhere else in California, are indeed growing. Employers continue to shed health insurance benefits or pass on rising health care costs to their employees.\u003c/p>\n\u003cp>Doug Macaulay, a Republican, has sold insurance to the residents of Oakhurst for nearly three decades, and, in that role, has heard just about everyone’s opinion of the federal health law.\u003c/p>\n\u003cp>\"I think there’s just a certain lack of knowledge of how health care works,\" he said.\u003c/p>\n\u003cp>Macaulay says people get mad at the insurance companies, but they don’t see ‘ObamaCare’, as they derisively call it, as the answer.\u003c/p>\n\u003cp>\"I get this all the time,\" Macaulay says, \"where there’s not really a connection between, 'Ok, here’s what the government is trying to do for you. You’re complaining over here that you don’t have health insurance and you can’t buy it. And over here they’re trying to provide you with it but that’s the worst thing… ever.' So there seems to be a disconnect in the thinking there because it gets in the way of what I want to think about my government.\u003c/p>\n\u003cp>Down the road from Doug Macaulay’s office, meanwhile, Paul Ruffino is preparing to welcome guests to Chateau du Sureau, a five-star, luxury inn that looks over the mountains of Yosemite.\u003c/p>\n\u003cp>Inside, there’s a fire burning in the grand salon and painted frescoes on the ceiling. Ruffino, the inn’s manager, is 55 years old. He’s a Libertarian. He finds the Republican party too liberal.\u003c/p>\n\u003cp>\"I’m uninsured! It’s the first time in my life and it’s probably when I need it the most,\" he said.\u003c/p>\n\u003cp>Ruffino says the plans he’s looked at are expensive and won’t cover his pre-existing conditions. Still, he says it was his decision to leave a previous job in Southern California that came with insurance and move to Oakhurst.\u003c/p>\n\u003cp>\"Do I make the government responsible for my choices,\" he asked rhetorically. \"I made the choice. I knew beforehand. I knew beforehand what was going on.\"\u003c/p>\n\u003cp>Ruffino seems torn between his unsparing self-reliance and a sense that the insurance industry is unfair. \"Would I like it to be better? There’s a greedy part of me that says that it would.\"\u003c/p>\n\u003cp>He thinks the insurance companies should NOT be allowed to pick out only the healthy and leave guys like him behind.\u003c/p>\n\u003cp>\"And that’s where I have to then ask: Does there come a time when government has to get involved and at what levels? But when you are distrustful of the system in whole it makes it difficult. I go back and forth. I ping pong on this issue all the time.\u003c/p>\n\u003cp>These conflicts - both personal and political - will be amplified next week when the Supreme Court considers just what role the government should play in re-making the country’s health insurance system.\u003c/p>\n\u003cp>\u003cem>Listen to the story:\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201203230850a.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201203230850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n","blocks":[],"excerpt":"Today marks the second anniversary of the federal health care law, and, unless you've been depriving yourself of news for the last several weeks, that same law will be front and center before the Supreme Court starting Monday. Here in California, uninsured Californians have a particular stake in the Court's actions. \r\n\r\nMadera County is a largely conservative and agricultural area where one in every three people lacks coverage. While many people say they want the Supreme Court to throw out the federal health law, I found that many there are struggling to reconcile their political views with the basic need for health insurance.","status":"publish","parent":0,"modified":1334013408,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1150},"headData":{"title":"Uninsured--and Still Against the Health Law | KQED","description":"Today marks the second anniversary of the federal health care law, and, unless you've been depriving yourself of news for the last several weeks, that same law will be front and center before the Supreme Court starting Monday. Here in California, uninsured Californians have a particular stake in the Court's actions. \r\n\r\nMadera County is a largely conservative and agricultural area where one in every three people lacks coverage. While many people say they want the Supreme Court to throw out the federal health law, I found that many there are struggling to reconcile their political views with the basic need for health insurance.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Uninsured--and Still Against the Health Law","datePublished":"2012-03-23T18:07:41.000Z","dateModified":"2012-04-09T23:16:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"4060 http://blogs.kqed.org/stateofhealth/?p=4060","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/23/uninsured-and-still-against-the-health-law/","disqusTitle":"Uninsured--and Still Against the Health Law","path":"/stateofhealth/4060/uninsured-and-still-against-the-health-law","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_4081\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/UninsuredVarney1.jpg\">\u003cimg class=\"size-medium wp-image-4081\" title=\"Libertarian Paul Ruffino, 55, has been looking for an insurance plan since leaving his previous job. Several insurance companies refuse to cover him because he has pre-existing conditions\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/UninsuredVarney1-300x169.jpg\" alt=\"Libertarian Paul Ruffino, 55, has been looking for an insurance plan since leaving his previous job. Several insurance companies refuse to cover him because he has pre-existing conditions. \" width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Libertarian Paul Ruffino, 55, has been looking for an insurance plan since leaving his previous job. Several insurance companies refuse to cover him because he has pre-existing conditions. (Photo: Sarah Varney)\u003c/figcaption>\u003c/figure>\n\u003cp>Today marks the second anniversary of the federal health care law, and, unless you've been depriving yourself of news for the last several weeks, that same law will be front and center before the Supreme Court starting Monday. Here in California, uninsured Californians have a particular stake in the Court's actions.\u003c/p>\n\u003cp>Madera County is a largely conservative and agricultural area where one in every three people lacks coverage. While many people say they want the Supreme Court to throw out the federal health law, I found that many there are struggling to reconcile their political views with the basic need for health insurance.\u003c/p>\n\u003cp>I started off in Oakhurst. Here, just a few miles from the entrance to Yosemite National Park, is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama’s signature initiative, including people like Joe Stern. \"ObamaCare is absolutely horrible, horrible, horrible. It should struck down immediately.\"\u003c!--more-->\u003c/p>\n\u003cp>Stern sips on a glass of pinot noir. He’s 66 years old, a registered Republican and owns a small water conditioning company. He is covered by Medicare, and he says he’s thankful for the program. Before he turned 65, Stern paid mightily for his health insurance.\u003c/p>\n\u003cp>\"I, a single person, was paying $670 a month,\" he told me. \"I thought it was pretty brutal but I was still against ObamaCare by far, ‘cause I saw how they did it in the middle of the night. It was just totally, it’s not how you do a radical change like that. You do it slowly.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If at all. Like many conservative voters I interviewed in Madera County, Stern despises the individual mandate included in the law, the requirement that all Americans have health coverage.\u003c/p>\n\u003cp>There is a lot of suspicion here about whether the health insurance system is really all that broken. Stern thinks many people choose to be uninsured, and in a sentiment I heard from nearly everyone I interviewed, Stern says no one is denied medical care.\u003c/p>\n\u003cp>\"I don’t know of anyone that was left on the street to bleed to death,\" he says. \"I don’t know anyone that is really left out.\"\u003c/p>\n\u003cp>I asked Stern if he knew anyone at the bar who is uninsured. He turned cheerfully to his friend Mary Westover sitting next to him. Westover was coy about her age. She’s maybe 50-ish. She’s a registered Republican and self-employed artist and businesswoman. She’s been uninsured for 17 years.\u003c/p>\n\u003cp>\"When I was married I had insurance through my husband. Since we got divorced, I was self employed. I just couldn’t afford it. I couldn’t afford the premiums. I was flying by the seat of my pants every inch of the way,\" Westover said.\u003c/p>\n\u003cp>It’s been nearly two decades since Westover has had a pap smear or a mammogram. She says she just tries to take care of herself. She’s opposed to the individual mandate but says she wasn’t aware the federal government would give subsidies to people like her to buy a policy.\u003c/p>\n\u003cp>\"If it were subsidized, if it were made, you know, manageable, I would want that,\" Westover told me. \"And I don’t know how people who can afford it, can sit there and say that we shouldn’t have that. Because there are a lot more of us, than them.\"\u003c/p>\n\u003cp>The ranks of the uninsured in Oakhurst, like everywhere else in California, are indeed growing. Employers continue to shed health insurance benefits or pass on rising health care costs to their employees.\u003c/p>\n\u003cp>Doug Macaulay, a Republican, has sold insurance to the residents of Oakhurst for nearly three decades, and, in that role, has heard just about everyone’s opinion of the federal health law.\u003c/p>\n\u003cp>\"I think there’s just a certain lack of knowledge of how health care works,\" he said.\u003c/p>\n\u003cp>Macaulay says people get mad at the insurance companies, but they don’t see ‘ObamaCare’, as they derisively call it, as the answer.\u003c/p>\n\u003cp>\"I get this all the time,\" Macaulay says, \"where there’s not really a connection between, 'Ok, here’s what the government is trying to do for you. You’re complaining over here that you don’t have health insurance and you can’t buy it. And over here they’re trying to provide you with it but that’s the worst thing… ever.' So there seems to be a disconnect in the thinking there because it gets in the way of what I want to think about my government.\u003c/p>\n\u003cp>Down the road from Doug Macaulay’s office, meanwhile, Paul Ruffino is preparing to welcome guests to Chateau du Sureau, a five-star, luxury inn that looks over the mountains of Yosemite.\u003c/p>\n\u003cp>Inside, there’s a fire burning in the grand salon and painted frescoes on the ceiling. Ruffino, the inn’s manager, is 55 years old. He’s a Libertarian. He finds the Republican party too liberal.\u003c/p>\n\u003cp>\"I’m uninsured! It’s the first time in my life and it’s probably when I need it the most,\" he said.\u003c/p>\n\u003cp>Ruffino says the plans he’s looked at are expensive and won’t cover his pre-existing conditions. Still, he says it was his decision to leave a previous job in Southern California that came with insurance and move to Oakhurst.\u003c/p>\n\u003cp>\"Do I make the government responsible for my choices,\" he asked rhetorically. \"I made the choice. I knew beforehand. I knew beforehand what was going on.\"\u003c/p>\n\u003cp>Ruffino seems torn between his unsparing self-reliance and a sense that the insurance industry is unfair. \"Would I like it to be better? There’s a greedy part of me that says that it would.\"\u003c/p>\n\u003cp>He thinks the insurance companies should NOT be allowed to pick out only the healthy and leave guys like him behind.\u003c/p>\n\u003cp>\"And that’s where I have to then ask: Does there come a time when government has to get involved and at what levels? But when you are distrustful of the system in whole it makes it difficult. I go back and forth. I ping pong on this issue all the time.\u003c/p>\n\u003cp>These conflicts - both personal and political - will be amplified next week when the Supreme Court considers just what role the government should play in re-making the country’s health insurance system.\u003c/p>\n\u003cp>\u003cem>Listen to the story:\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201203230850a.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201203230850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/4060/uninsured-and-still-against-the-health-law","authors":["8310"],"categories":["stateofhealth_166","stateofhealth_15"],"tags":["stateofhealth_222","stateofhealth_119","stateofhealth_79"],"featImg":"stateofhealth_4081","label":"stateofhealth"},"stateofhealth_3826":{"type":"posts","id":"stateofhealth_3826","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"3826","score":null,"sort":[1332194150000]},"guestAuthors":[],"slug":"the-supreme-courts-4-health-care-reform-questions","title":"The 4 Health Care Overhaul Questions Before the Supreme Court","publishDate":1332194150,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>\u003cem>The Supreme Court issued its decisions on the Affordable Care Act on June 28, 2012. This post has been updated to reflect the court’s rulings.\u003c/em>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4289\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourtJustices_2012_032620121.jpg\">\u003cimg class=\"size-medium wp-image-4289\" title=\"(Courtesy: U.S. Supreme Court)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourtJustices_2012_032620121-300x240.jpg\" alt=\"(Courtesy: U.S. Supreme Court)\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: U.S. Supreme Court)\u003c/figcaption>\u003c/figure>\n\u003cp>Next Monday, the Supreme Court begins considering the Constitutionality of the \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">Affordable Care Act\u003c/a>, or ACA. Three days, six hours of oral arguments. But it's not just one long slog about health care reform. The Supreme Court is considering four different questions over those three days.\u003c/p>\n\u003cp>Legal scholars, pundits and those suitably opinionated have been pontificating about all kinds of legal issues. But the average American might want to know, in straightforward language, what those Four Questions actually mean.\u003c/p>\n\u003cp>Here's my take on them:\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>1. Can the Supreme Court Consider the ACA Now, Anyway?\u003c/strong>\u003cbr>\nOral arguments Monday, March 26, 7-8:30am PT\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This is a question only lawyers can love. Feel free to skip to Question #2 if you like. If you're still with me, start by going 140 years back in time to the \u003ca title=\"http://www.law.cornell.edu/uscode/text/26/7421\" href=\"http://www.law.cornell.edu/uscode/text/26/7421\" target=\"_blank\">1867 Tax Anti-Junction Act\u003c/a>. No, I'm not making this up--it's the crux of this first question before the Supreme Court. Here's the deal: the ACA requires that people purchase health insurance or pay a penalty. Many people say this \"penalty\" is a tax in disguise. The Tax Anti-Injunction Act bars people from suing over a tax \u003cem>until they actually pay the tax.\u003c/em> Since the ACA goes into full effect in 2014, no penalties will be paid until 2015. And so, 2015 would be the soonest someone who paid the tax could challenge the constitutionality of the ACA. Will the Supreme Court punt and say, \"Come back in 2015\"? Court-watchers say that's unlikely. \u003cstrong>SPECIAL NOTE: \u003c/strong>If you can only pay attention to two of the three days of hearings, this is your day to skip.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: The Supreme Court determined it had the authority to rule.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>2. Is the Individual Mandate Constitutional?\u003c/strong>\u003cbr>\nOral arguments Tuesday, March 27, 7-9am PT\u003c/p>\n\u003cp>Of the four questions the Supreme Court is considering, this is the big one. As you learned in Question #1, the ACA requires all Americans to purchase health insurance or pay a penalty/tax. If your annual income is below a certain level--about $92,000 for a family of four-- the government will provide subsidies or tax credits to help you. But the mandate is unpopular. Just \u003ca title=\"http://www.kff.org/kaiserpolls/upload/8285-F.pdf\" href=\"http://www.kff.org/kaiserpolls/upload/8285-F.pdf\" target=\"_blank\">over half of Americans\u003c/a> think the Supreme Court should declare the mandate unconstitutional, while 28 percent think it should stay. The primary legal question is this: does Congress have the authority under the \u003ca title=\"http://www.law.cornell.edu/wex/commerce_clause\" href=\"http://www.law.cornell.edu/wex/commerce_clause\" target=\"_blank\">Commerce Clause\u003c/a> of the U.S. Constitution to require Americans to purchase a product, in this case health insurance? Those in favor say yes--Congress can both regulate interstate commerce and legislate taxes. Those opposed say this is the first time Congress has required Americans to purchase a product and it's unconstitutional. \u003cstrong>SPECIAL NOTE:\u003c/strong> if your employer provides health insurance or if you are a Medicare recipient, nothing about your personal situation will change. On January 1, 2014, you would continue to receive the same employer-based coverage or Medicare.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: In a 5-4 ruling, the Supreme Court determined that the individual mandate is constitutional.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>3. If the Individual Mandate is Unconstitutional, Can the Rest of the ACA Go Forward?\u003c/strong>\u003cbr>\nOral arguments Wednesday, March 28, 7-8:30am PT\u003c/p>\n\u003cp>Severability. This word will be all over the news next Wednesday. Why? Suppose the Supreme Court decides the individual mandate is unconstitutional. Can the mandate be \"severed\" from the ACA, allowing the ACA to stand? This question has a bit of unusual background: normally when Congress writes a law, it includes a \"severability\" clause, so that if one part of a law is struck down, the rest of the law can still stand. Back in the last days of drafting the ACA, the House version indeed had a severability clause. The Senate side expected to add it in a conference committee. But things got so hectic at the end, there was never a conference committee and the severability clause was not part of the final law. \u003cstrong>SPECIAL NOTE:\u003c/strong> many experts think severability is implied. They say if the individual mandate is struck down, the rest of the law can stand. Only the Supreme Court will say for sure.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: The question of “severability” became irrelevant since the Supreme Court determined that the individual mandate is constitutional. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>4. Is the Medicaid Expansion Constitutional?\u003c/strong>\u003c/em>\u003cbr>\nOral arguments Wednesday, March 28, 10-11am PT\u003c/p>\n\u003cp>\u003ca title=\"http://www.medicaid.gov/\" href=\"http://www.medicaid.gov/\" target=\"_blank\">Medicaid\u003c/a> is the health care plan for the poor and disabled that is run by individual states with both state and federal dollars. The Affordable Care Act expands those eligible for Medicaid to adults earning 133 percent of the federal poverty level. But in order for states to continue receiving \u003cem>any\u003c/em> federal money for Medicaid, the ACA requires them to comply with this expansion. Twenty-six states who have challenged this requirement say withholding all monies for Medicaid is coercive and therefore unconstitutional. Those states which support the expansion--including California--say that Congress can constitutionally attach such conditions under what's known as the \"Spending Clause.\" \u003cstrong>SPECIAL NOTE:\u003c/strong> Congress has expanded Medicaid many times in the past and never had an expansion struck down.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: The Supreme Court ruled 5-4 that Congress may not take away all funds for Medicaid if a state decides not to expand the program. As of January 2013, many states have determined to go forward with the expansion; the federal government will pay 100 percent of the costs of any newly eligible enrollees for the first three years and not less than 90 percent of the cost thereafter. Other states have said they will not expand the program; Congress must continue to fund a state's existing Medicaid program at the existing level.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Some final thoughts:\u003c/strong>\u003c/p>\n\u003cp>The Supreme Court's decisions are expected in late June, possibly early July.\u003cbr>\n\u003cem>Update: as noted, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/06/28/supreme-court-health-care-decision/\" target=\"_blank\">the decisions\u003c/a> came down June 28, 2012.\u003c/em>\u003c/p>\n\u003cp>The Court will make audio recordings available following the end of arguments each day, but turned down requests for live TV or radio broadcasts.\u003cbr>\n\u003cem>Update:\u003c/em> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/28/audiotranscripts-of-wednesdays-supreme-court-hearings-on-the-fate-of-the-health-law/\" target=\"_blank\">Oral arguments and transcripts on the Medicaid expansion and individual mandate. \u003c/a>\u003c/p>\n\u003cp>While some elements of the Affordable Care Act have already gone into effect, the major components of the legislation take effect on January 1, 2014.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>Background on the Individual Mandate: \u003ca title=\"http://news.yahoo.com/court-weighs-making-health-coverage-fact-life-133951595.html\" href=\"http://news.yahoo.com/court-weighs-making-health-coverage-fact-life-133951595.html\" target=\"_blank\">Court Weighs Making Health Coverage a Fact of Life\u003c/a> (AP)\u003c/p>\n\u003cp>\u003ca title=\"http://www.kff.org/healthreform/upload/8270-2.pdf\" href=\"http://www.kff.org/healthreform/upload/8270-2.pdf\" target=\"_blank\">A Guide to the Supreme Court’s Review of the 2010 Health Care Reform Law\u003c/a> [PDF] (Kaiser Family Foundation)\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>And for you wonks out there, you can find content galore here:\u003cbr>\n\u003ca title=\"http://www.kaiserhealthnews.org/Supreme-Court-Decides-Health-Law.aspx\" href=\"http://www.kaiserhealthnews.org/Supreme-Court-Decides-Health-Law.aspx\" target=\"_blank\">The Supreme Court Decides: Health Care at the High Court\u003c/a> (Kaiser Health News)\u003c/p>\n\n","blocks":[],"excerpt":"Next Monday, the Supreme Court begins considering the Constitutionality of the Affordable Care Act, or ACA. Three days, six hours of oral arguments. But it's not just one long slog about health care reform. The Supreme Court is considering four different questions over those three days.\r\n\r\nLegal scholars, pundits and those suitably opinionated have been pontificating about all kinds of legal issues. But the average American might want to know, in straightforward language, what those Four Questions actually mean.\r\n\r\nHere's my take on them:","status":"publish","parent":0,"modified":1377635096,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1145},"headData":{"title":"The 4 Health Care Overhaul Questions Before the Supreme Court | KQED","description":"Next Monday, the Supreme Court begins considering the Constitutionality of the Affordable Care Act, or ACA. Three days, six hours of oral arguments. But it's not just one long slog about health care reform. The Supreme Court is considering four different questions over those three days.\r\n\r\nLegal scholars, pundits and those suitably opinionated have been pontificating about all kinds of legal issues. But the average American might want to know, in straightforward language, what those Four Questions actually mean.\r\n\r\nHere's my take on them:","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The 4 Health Care Overhaul Questions Before the Supreme Court","datePublished":"2012-03-19T21:55:50.000Z","dateModified":"2013-08-27T20:24:56.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3826 http://blogs.kqed.org/stateofhealth/?p=3826","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/03/19/the-supreme-courts-4-health-care-reform-questions/","disqusTitle":"The 4 Health Care Overhaul Questions Before the Supreme Court","path":"/stateofhealth/3826/the-supreme-courts-4-health-care-reform-questions","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>\u003cem>The Supreme Court issued its decisions on the Affordable Care Act on June 28, 2012. This post has been updated to reflect the court’s rulings.\u003c/em>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4289\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourtJustices_2012_032620121.jpg\">\u003cimg class=\"size-medium wp-image-4289\" title=\"(Courtesy: U.S. Supreme Court)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/03/SupremeCourtJustices_2012_032620121-300x240.jpg\" alt=\"(Courtesy: U.S. Supreme Court)\" width=\"300\" height=\"240\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: U.S. Supreme Court)\u003c/figcaption>\u003c/figure>\n\u003cp>Next Monday, the Supreme Court begins considering the Constitutionality of the \u003ca title=\"http://www.healthcare.gov/law/index.html\" href=\"http://www.healthcare.gov/law/index.html\" target=\"_blank\">Affordable Care Act\u003c/a>, or ACA. Three days, six hours of oral arguments. But it's not just one long slog about health care reform. The Supreme Court is considering four different questions over those three days.\u003c/p>\n\u003cp>Legal scholars, pundits and those suitably opinionated have been pontificating about all kinds of legal issues. But the average American might want to know, in straightforward language, what those Four Questions actually mean.\u003c/p>\n\u003cp>Here's my take on them:\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>1. Can the Supreme Court Consider the ACA Now, Anyway?\u003c/strong>\u003cbr>\nOral arguments Monday, March 26, 7-8:30am PT\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This is a question only lawyers can love. Feel free to skip to Question #2 if you like. If you're still with me, start by going 140 years back in time to the \u003ca title=\"http://www.law.cornell.edu/uscode/text/26/7421\" href=\"http://www.law.cornell.edu/uscode/text/26/7421\" target=\"_blank\">1867 Tax Anti-Junction Act\u003c/a>. No, I'm not making this up--it's the crux of this first question before the Supreme Court. Here's the deal: the ACA requires that people purchase health insurance or pay a penalty. Many people say this \"penalty\" is a tax in disguise. The Tax Anti-Injunction Act bars people from suing over a tax \u003cem>until they actually pay the tax.\u003c/em> Since the ACA goes into full effect in 2014, no penalties will be paid until 2015. And so, 2015 would be the soonest someone who paid the tax could challenge the constitutionality of the ACA. Will the Supreme Court punt and say, \"Come back in 2015\"? Court-watchers say that's unlikely. \u003cstrong>SPECIAL NOTE: \u003c/strong>If you can only pay attention to two of the three days of hearings, this is your day to skip.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: The Supreme Court determined it had the authority to rule.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>2. Is the Individual Mandate Constitutional?\u003c/strong>\u003cbr>\nOral arguments Tuesday, March 27, 7-9am PT\u003c/p>\n\u003cp>Of the four questions the Supreme Court is considering, this is the big one. As you learned in Question #1, the ACA requires all Americans to purchase health insurance or pay a penalty/tax. If your annual income is below a certain level--about $92,000 for a family of four-- the government will provide subsidies or tax credits to help you. But the mandate is unpopular. Just \u003ca title=\"http://www.kff.org/kaiserpolls/upload/8285-F.pdf\" href=\"http://www.kff.org/kaiserpolls/upload/8285-F.pdf\" target=\"_blank\">over half of Americans\u003c/a> think the Supreme Court should declare the mandate unconstitutional, while 28 percent think it should stay. The primary legal question is this: does Congress have the authority under the \u003ca title=\"http://www.law.cornell.edu/wex/commerce_clause\" href=\"http://www.law.cornell.edu/wex/commerce_clause\" target=\"_blank\">Commerce Clause\u003c/a> of the U.S. Constitution to require Americans to purchase a product, in this case health insurance? Those in favor say yes--Congress can both regulate interstate commerce and legislate taxes. Those opposed say this is the first time Congress has required Americans to purchase a product and it's unconstitutional. \u003cstrong>SPECIAL NOTE:\u003c/strong> if your employer provides health insurance or if you are a Medicare recipient, nothing about your personal situation will change. On January 1, 2014, you would continue to receive the same employer-based coverage or Medicare.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: In a 5-4 ruling, the Supreme Court determined that the individual mandate is constitutional.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>3. If the Individual Mandate is Unconstitutional, Can the Rest of the ACA Go Forward?\u003c/strong>\u003cbr>\nOral arguments Wednesday, March 28, 7-8:30am PT\u003c/p>\n\u003cp>Severability. This word will be all over the news next Wednesday. Why? Suppose the Supreme Court decides the individual mandate is unconstitutional. Can the mandate be \"severed\" from the ACA, allowing the ACA to stand? This question has a bit of unusual background: normally when Congress writes a law, it includes a \"severability\" clause, so that if one part of a law is struck down, the rest of the law can still stand. Back in the last days of drafting the ACA, the House version indeed had a severability clause. The Senate side expected to add it in a conference committee. But things got so hectic at the end, there was never a conference committee and the severability clause was not part of the final law. \u003cstrong>SPECIAL NOTE:\u003c/strong> many experts think severability is implied. They say if the individual mandate is struck down, the rest of the law can stand. Only the Supreme Court will say for sure.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: The question of “severability” became irrelevant since the Supreme Court determined that the individual mandate is constitutional. \u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>\u003cstrong>4. Is the Medicaid Expansion Constitutional?\u003c/strong>\u003c/em>\u003cbr>\nOral arguments Wednesday, March 28, 10-11am PT\u003c/p>\n\u003cp>\u003ca title=\"http://www.medicaid.gov/\" href=\"http://www.medicaid.gov/\" target=\"_blank\">Medicaid\u003c/a> is the health care plan for the poor and disabled that is run by individual states with both state and federal dollars. The Affordable Care Act expands those eligible for Medicaid to adults earning 133 percent of the federal poverty level. But in order for states to continue receiving \u003cem>any\u003c/em> federal money for Medicaid, the ACA requires them to comply with this expansion. Twenty-six states who have challenged this requirement say withholding all monies for Medicaid is coercive and therefore unconstitutional. Those states which support the expansion--including California--say that Congress can constitutionally attach such conditions under what's known as the \"Spending Clause.\" \u003cstrong>SPECIAL NOTE:\u003c/strong> Congress has expanded Medicaid many times in the past and never had an expansion struck down.\u003c/p>\n\u003cp>\u003cstrong>\u003cem>Update: The Supreme Court ruled 5-4 that Congress may not take away all funds for Medicaid if a state decides not to expand the program. As of January 2013, many states have determined to go forward with the expansion; the federal government will pay 100 percent of the costs of any newly eligible enrollees for the first three years and not less than 90 percent of the cost thereafter. Other states have said they will not expand the program; Congress must continue to fund a state's existing Medicaid program at the existing level.\u003c/em>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Some final thoughts:\u003c/strong>\u003c/p>\n\u003cp>The Supreme Court's decisions are expected in late June, possibly early July.\u003cbr>\n\u003cem>Update: as noted, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/06/28/supreme-court-health-care-decision/\" target=\"_blank\">the decisions\u003c/a> came down June 28, 2012.\u003c/em>\u003c/p>\n\u003cp>The Court will make audio recordings available following the end of arguments each day, but turned down requests for live TV or radio broadcasts.\u003cbr>\n\u003cem>Update:\u003c/em> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/03/28/audiotranscripts-of-wednesdays-supreme-court-hearings-on-the-fate-of-the-health-law/\" target=\"_blank\">Oral arguments and transcripts on the Medicaid expansion and individual mandate. \u003c/a>\u003c/p>\n\u003cp>While some elements of the Affordable Care Act have already gone into effect, the major components of the legislation take effect on January 1, 2014.\u003c/p>\n\u003cp>\u003cstrong>Learn More:\u003c/strong>\u003c/p>\n\u003cp>Background on the Individual Mandate: \u003ca title=\"http://news.yahoo.com/court-weighs-making-health-coverage-fact-life-133951595.html\" href=\"http://news.yahoo.com/court-weighs-making-health-coverage-fact-life-133951595.html\" target=\"_blank\">Court Weighs Making Health Coverage a Fact of Life\u003c/a> (AP)\u003c/p>\n\u003cp>\u003ca title=\"http://www.kff.org/healthreform/upload/8270-2.pdf\" href=\"http://www.kff.org/healthreform/upload/8270-2.pdf\" target=\"_blank\">A Guide to the Supreme Court’s Review of the 2010 Health Care Reform Law\u003c/a> [PDF] (Kaiser Family Foundation)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And for you wonks out there, you can find content galore here:\u003cbr>\n\u003ca title=\"http://www.kaiserhealthnews.org/Supreme-Court-Decides-Health-Law.aspx\" href=\"http://www.kaiserhealthnews.org/Supreme-Court-Decides-Health-Law.aspx\" target=\"_blank\">The Supreme Court Decides: Health Care at the High Court\u003c/a> (Kaiser Health News)\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/3826/the-supreme-courts-4-health-care-reform-questions","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_38","stateofhealth_222","stateofhealth_41","stateofhealth_119","stateofhealth_402"],"featImg":"stateofhealth_4289","label":"stateofhealth"},"stateofhealth_2563":{"type":"posts","id":"stateofhealth_2563","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"2563","score":null,"sort":[1327609306000]},"guestAuthors":[],"slug":"without-individual-mandate-fewer-californians-with-health-insurance","title":"Without Individual Mandate, Fewer Californians with Health Insurance","publishDate":1327609306,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_2574\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114.jpg\">\u003cimg class=\"size-medium wp-image-2574\" title=\"(s_falkow: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-300x198.jpg\" alt=\"(s_falkow: Flickr)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In March, the U.S. Supreme Court will \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/15/the-4-health-care-reform-questions-before-the-supreme-court/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/15/the-4-health-care-reform-questions-before-the-supreme-court/\" target=\"_blank\">consider the constitutionality\u003c/a> of several aspects of health care reform, including the \"individual mandate,\" the requirement that all Americans have health insurance.\u003c/p>\n\u003cp>In a \u003ca title=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" href=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" target=\"_blank\">new study\u003c/a>, [PDF] researchers at the \u003ca title=\"http://www.healthpolicy.ucla.edu/\" href=\"http://www.healthpolicy.ucla.edu/\" target=\"_blank\">UCLA Center for Health Policy Research\u003c/a> and \u003ca title=\"http://laborcenter.berkeley.edu/\" href=\"http://laborcenter.berkeley.edu/\" target=\"_blank\">UC Berkeley\u003c/a> crunched the numbers and determined that without the individual mandate, more than one million Californians would put off buying health insurance.\u003c/p>\n\u003cp>The individual mandate is part of \u003ca title=\"http://www.healthcare.gov/law/full/\" href=\"http://www.healthcare.gov/law/full/\" target=\"_blank\">The Affordable Care Act\u003c/a>, set to roll out in 2014. The mandate requires people to purchase health insurance or pay a tax penalty up to $2085 per household.\u003c!--more-->\u003c/p>\n\u003cp>\"There no question that the mandate makes a huge difference in bringing people under the umbrella of coverage,\" Gerald Kominski, co-author of the study, said in a press release. \"Eliminating the mandate will undermine the goal of health care reform to substantially increase health insurance coverage for the uninsured.\"\u003c/p>\n\u003cp>In addition, if there's no mandate, the researchers say the state insurance market will continue to see \"adverse selection,\" meaning people who have serious health conditions are most motivated to obtain health insurance. With fewer healthy people buying insurance, it's harder to spread risk. This situation drives up health care costs, which translates to higher costs of health insurance itself. The higher premiums will further push people out of the health insurance market, the researchers believe.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study was funded by \u003ca title=\"http://www.calendow.org/\" href=\"http://www.calendow.org/\" target=\"_blank\">The California Endowment\u003c/a>, which also supports KQED.\u003c/p>\n\u003cp>In another health care reform story today, the Kaiser Family Foundation released its \u003ca title=\"http://www.kff.org/kaiserpolls/8274.cfm\" href=\"http://www.kff.org/kaiserpolls/8274.cfm\" target=\"_blank\">January Health Tracking Poll\u003c/a>. The survey showed that most Americans believe the Supreme Court Justices will base their rulings about health care reform on their own personal views, rather than interpretation of the law.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>More specifically, the poll found:\u003c/p>\n\u003cblockquote>\u003cp>Three-quarters (75%) say they think that, in general, Justices let their own ideological views influence their decisions while 17 percent say they usually decide cases based on legal analysis without regard to politics and ideology. Similarly, when asked specifically about the challenge to the individual mandate in the health reform law, six in ten (59%) Americans say they expect the Justices will take their own ideological views into account, while 28 percent think their decision will be based purely on legal analysis and interpretation.\u003c/p>\u003c/blockquote>\n\u003cdiv id=\"cs_control_5386\">\n\u003cdiv>As for the individual mandate itself, more than twice as many Americans have an unfavorable rather than favorable view of the mandate (67% to 30%). This is line with prior Kaiser polls. More than half of those polled (54%) said the Court should rule the individual mandate unconstitutional.\u003c/div>\n\u003c/div>\n\n","blocks":[],"excerpt":"In March, the U.S. Supreme Court will consider the constitutionality of several aspects of health care reform, including the \"individual mandate,\" the requirement that all Americans have health insurance.\r\n\r\nIn a new study, [PDF] researchers at the UCLA Center for Health Policy Research and UC Berkeley crunched the numbers and determined that without the individual mandate, more than one million Californians would put off buying health insurance.","status":"publish","parent":0,"modified":1332537674,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":436},"headData":{"title":"Without Individual Mandate, Fewer Californians with Health Insurance | KQED","description":"In March, the U.S. Supreme Court will consider the constitutionality of several aspects of health care reform, including the "individual mandate," the requirement that all Americans have health insurance.\r\n\r\nIn a new study, researchers at the UCLA Center for Health Policy Research and UC Berkeley crunched the numbers and determined that without the individual mandate, more than one million Californians would put off buying health insurance.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Without Individual Mandate, Fewer Californians with Health Insurance","datePublished":"2012-01-26T20:21:46.000Z","dateModified":"2012-03-23T21:21:14.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2563 http://blogs.kqed.org/stateofhealth/?p=2563","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/01/26/without-individual-mandate-fewer-californians-with-health-insurance/","disqusTitle":"Without Individual Mandate, Fewer Californians with Health Insurance","path":"/stateofhealth/2563/without-individual-mandate-fewer-californians-with-health-insurance","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2574\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114.jpg\">\u003cimg class=\"size-medium wp-image-2574\" title=\"(s_falkow: Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-300x198.jpg\" alt=\"(s_falkow: Flickr)\" width=\"300\" height=\"198\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In March, the U.S. Supreme Court will \u003ca title=\"http://ww2.kqed.org/stateofhealth/2011/11/15/the-4-health-care-reform-questions-before-the-supreme-court/\" href=\"http://ww2.kqed.org/stateofhealth/2011/11/15/the-4-health-care-reform-questions-before-the-supreme-court/\" target=\"_blank\">consider the constitutionality\u003c/a> of several aspects of health care reform, including the \"individual mandate,\" the requirement that all Americans have health insurance.\u003c/p>\n\u003cp>In a \u003ca title=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" href=\"http://www.healthpolicy.ucla.edu/pubs/files/calsim_mandate.pdf\" target=\"_blank\">new study\u003c/a>, [PDF] researchers at the \u003ca title=\"http://www.healthpolicy.ucla.edu/\" href=\"http://www.healthpolicy.ucla.edu/\" target=\"_blank\">UCLA Center for Health Policy Research\u003c/a> and \u003ca title=\"http://laborcenter.berkeley.edu/\" href=\"http://laborcenter.berkeley.edu/\" target=\"_blank\">UC Berkeley\u003c/a> crunched the numbers and determined that without the individual mandate, more than one million Californians would put off buying health insurance.\u003c/p>\n\u003cp>The individual mandate is part of \u003ca title=\"http://www.healthcare.gov/law/full/\" href=\"http://www.healthcare.gov/law/full/\" target=\"_blank\">The Affordable Care Act\u003c/a>, set to roll out in 2014. The mandate requires people to purchase health insurance or pay a tax penalty up to $2085 per household.\u003c!--more-->\u003c/p>\n\u003cp>\"There no question that the mandate makes a huge difference in bringing people under the umbrella of coverage,\" Gerald Kominski, co-author of the study, said in a press release. \"Eliminating the mandate will undermine the goal of health care reform to substantially increase health insurance coverage for the uninsured.\"\u003c/p>\n\u003cp>In addition, if there's no mandate, the researchers say the state insurance market will continue to see \"adverse selection,\" meaning people who have serious health conditions are most motivated to obtain health insurance. With fewer healthy people buying insurance, it's harder to spread risk. This situation drives up health care costs, which translates to higher costs of health insurance itself. The higher premiums will further push people out of the health insurance market, the researchers believe.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study was funded by \u003ca title=\"http://www.calendow.org/\" href=\"http://www.calendow.org/\" target=\"_blank\">The California Endowment\u003c/a>, which also supports KQED.\u003c/p>\n\u003cp>In another health care reform story today, the Kaiser Family Foundation released its \u003ca title=\"http://www.kff.org/kaiserpolls/8274.cfm\" href=\"http://www.kff.org/kaiserpolls/8274.cfm\" target=\"_blank\">January Health Tracking Poll\u003c/a>. The survey showed that most Americans believe the Supreme Court Justices will base their rulings about health care reform on their own personal views, rather than interpretation of the law.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>More specifically, the poll found:\u003c/p>\n\u003cblockquote>\u003cp>Three-quarters (75%) say they think that, in general, Justices let their own ideological views influence their decisions while 17 percent say they usually decide cases based on legal analysis without regard to politics and ideology. Similarly, when asked specifically about the challenge to the individual mandate in the health reform law, six in ten (59%) Americans say they expect the Justices will take their own ideological views into account, while 28 percent think their decision will be based purely on legal analysis and interpretation.\u003c/p>\u003c/blockquote>\n\u003cdiv id=\"cs_control_5386\">\n\u003cdiv>As for the individual mandate itself, more than twice as many Americans have an unfavorable rather than favorable view of the mandate (67% to 30%). This is line with prior Kaiser polls. More than half of those polled (54%) said the Court should rule the individual mandate unconstitutional.\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/2563/without-individual-mandate-fewer-californians-with-health-insurance","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_38","stateofhealth_222","stateofhealth_119"],"label":"stateofhealth"},"stateofhealth_1858":{"type":"posts","id":"stateofhealth_1858","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"1858","score":null,"sort":[1326219067000]},"guestAuthors":[],"slug":"great-subject-for-a-graphic-novel-health-reform","title":"Great Subject for a Graphic Novel: Health Reform","publishDate":1326219067,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_1867\" class=\"wp-caption alignleft\" style=\"max-width: 210px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/GruberBookCover_FullRes.jpg\">\u003cimg class=\"size-medium wp-image-1867\" title=\"(Courtesy: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/GruberBookCover_FullRes-300x427.jpg\" alt=\"(Courtesy: Kaiser Health News)\" width=\"210\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Michelle Andrews at \u003ca title=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2012/health-law-graphic-comic-book-Michelle-Andrews-Gruber.aspx\" href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2012/health-law-graphic-comic-book-Michelle-Andrews-Gruber.aspx\" target=\"_blank\">Kaiser Health News\u003c/a> features a Q&A today with MIT economist \u003ca title=\"http://econ-www.mit.edu/faculty/gruberj/shortbio\" href=\"http://econ-www.mit.edu/faculty/gruberj/shortbio\" target=\"_blank\">Jonathan Gruber,\u003c/a> who hatched the idea to inform people about health care reform via a graphic novel.\u003c/p>\n\u003cp>Key Takeaway? After health reform passed in Massachusetts, Gruber says, \"Premiums for individual market plans fell by 50 percent relative to national trends. The biggest surprise to me is that employer-sponsored health insurance actually went up after reform when it was falling everywhere else in the country.\"\u003c/p>\n\u003cdiv>\n\u003cp>No kidding. In California, employers offering health insurance fell from 73 percent to 63 percent in the last two years, according to a \u003ca title=\"http://www.chcf.org/publications/2011/12/employer-health-benefits\" href=\"http://www.chcf.org/publications/2011/12/employer-health-benefits\" target=\"_blank\">study\u003c/a> released just last week.\u003c/p>\n\u003cp>Here's Andrews complete story:\u003c/p>\n\u003cp>Nearly two years after the passage of the federal health law, more than 40 percent of people say they know little or nothing about how the law will affect them, according to the Kaiser Family Foundation's latest \u003ca title=\"http://www.kff.org/kaiserpolls/upload/8265-F.pdf\" href=\"http://www.kff.org/kaiserpolls/upload/8265-F.pdf\" target=\"_blank\">poll\u003c/a>. That figure hasn't budged since April 2010, just after the law was signed.\u003c!--more-->Jonathan Gruber, an economist at the Massachusetts Institute of Technology, aims to change that with a book, \u003ca title=\"http://us.macmillan.com/healthcarereform/JonathanGruber\" href=\"http://us.macmillan.com/healthcarereform/JonathanGruber\" target=\"_blank\">\"Health Care Reform: What It Is, Why It's Necessary, How It Works\u003c/a>.\" It explains the ins and outs of the law in an innovative way: an adult comic-strip form similar to graphic novels.\u003c/p>\n\u003cdiv>\n\u003cp>Gruber was one of the architects of the Massachusetts' health care overhaul, which included many features that appear in the federal law, and he advised the Obama administration and Congress on the Affordable Care Act. I spoke with him about his new book, which he co-authored with HP Newquist. The book is illustrated by Nathan Schreiber.\u003c/p>\n\u003cp>\u003cstrong>Q. What made you decide to write a book for consumers about health reform?\u003c/strong>\u003c/p>\n\u003cp>A. I think what really inspired me was hearing that when you polled consumers about the Affordable Care Act they were split in their support. But when you polled them about individual pieces of the law, they liked it. As an educator, you didn't have to do any more than explain what the law did [to gain support]. It needed to be explained in a way that people understood.\u003c/p>\n\u003cp>\u003cstrong>Q. Why did you choose a graphic novel format?\u003c/strong>\u003c/p>\n\u003cp>A. The publisher approached me about doing it that way. At first I wasn't that enthusiastic. I didn’t think it would be that effective. But the publisher said they had done a graphic novel about the \u003ca title=\"http://us.macmillan.com/the911report-1/SidJacobson\" href=\"http://us.macmillan.com/the911report-1/SidJacobson\" target=\"_blank\">9/11 Report\u003c/a>. My son likes graphic novels, he's 17. He said it's a great opportunity, it's a great medium. When you're on a plane and they want to teach you what to do in case of accident, they hand you a graphic. I think it was the right call.\u003c/p>\n\u003cp>\u003cstrong>Q. Who's the primary audience for this book?\u003c/strong>\u003c/p>\n\u003cp>A. I wrote it for the person who is confused and open-minded about this bill. The person who doesn't understand it. The two groups I really hope will read it and benefit from it are the independent voter who was inclined to like Obama and knows it's a big, transformative bill and wants to learn more, and the disaffected Democratic voter. I'm stunned that many don't support it.\u003c/p>\n\u003cp>\u003cstrong>Q. Do you think it will change any minds? Turn opponents into supporters?\u003c/strong>\u003c/p>\n\u003cp>A. I don't think it's going to change the minds of anyone who's convinced it's a bad piece of legislation. But it could change the minds of those who are wary and concerned.\u003c/p>\n\u003cp>\u003cstrong>Q. You showcase Massachusetts as an example of how health reform can work, noting that it employs some of the same elements that appear in the federal law, like the individual mandate that requires people to have insurance. What should readers be aware of about Massachusetts' experience with health reform? Has anything surprised you?\u003c/strong>\u003c/p>\n\u003cp>A. I would say the point the book tries to make is that Massachusetts was successful in what it tried to do. It reduced the number of uninsured and lowered non-group insurance premiums. Premiums for individual market plans fell by 50 percent relative to national trends. The biggest surprise to me is that employer-sponsored health insurance actually went up after reform when it was falling everywhere else in the country. It speaks to the power of the [individual] mandate. People said, \"Give me health insurance,\" and they did.\u003c/p>\n\u003cp>\u003cstrong>Q. You talk about how health care reform will help Anthony, Betty, Carlos and Dinah, all of whom have different health insurance situations. But you don’t discuss what will happen to Emilio the undocumented worker, who won't get coverage under the new law. Did you consider talking about who loses out under health reform, including the roughly \u003ca title=\"http://www.pewhispanic.org/2011/02/01/unauthorized-immigrant-population-brnational-and-state-trends-2010/\" href=\"http://www.pewhispanic.org/2011/02/01/unauthorized-immigrant-population-brnational-and-state-trends-2010/\" target=\"_blank\">11 million\u003c/a> illegal immigrants?\u003c/strong>\u003c/p>\n\u003cp>A. You hit on a great issue: Who loses out under the law. People don't lose out. Emilio doesn't lose out, he just doesn't gain. A lot of people don't gain. By design, the bill leaves a lot of people alone, including those with employer-sponsored insurance. They don't lose but they don't gain either. As for undocumented immigrants, there was no support to help them. Unfortunately, the law leaves them out in the cold. That was just a political reality.\u003c/p>\n\u003cp>\u003cstrong>Q. I know it's a big piece of legislation and you were trying to cover a lot of ground, but I couldn’t help thinking as I read the book that in some places you oversimplified in such a way that it made the law look better than it is. Can you talk a bit about concerns some may have that you may confuse readers by making sweeping statements about the benefits of this law?\u003c/strong>\u003c/p>\n\u003cp>A. Certainly I wrestled a lot with where to simplify and where not to. I think I tried my best to never be misleading. At the end of the book there's a set of references where people can go to learn more about the law. I think the truth is that most people don't want that level of detail. It's for people who just want to know what the heck is this bill.\u003c/p>\n\u003cp>\u003cstrong>Q. In the book you discuss the long-term care program created under the law, the CLASS Act, which the administration has decided not to implement, at least not at this time. Obviously, this law is changing and evolving. Depending on what happens in the next election, it could change a lot. What do you think is going to happen? Do you have any plans to update the book?\u003c/strong>\u003c/p>\n\u003cp>A. I am fairly confident, I think there's a better than 50 percent chance, for the Supreme Court not to turn down the mandate, and voters not to kick Obama out of office. If both those things go that way, I think it will be an incredibly positive thing for the Democrats in 2016. It will be good for them because the law will be doing good things by then. States need to move more quickly if we're going to implement the law smoothly. I can see it starting out roughly and being in great shape in a year or two.\u003c/p>\n\u003cp>My guess is I wouldn't want to update [the book]. I haven't really thought about that.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Michelle Andrews at Kaiser Health News features a Q&A today with MIT economist Jonathan Gruber, who hatched the idea to inform people about health care reform via a graphic novel.\r\n\r\nKey Takeaway? After health reform passed in Massachusetts, Gruber says, \"Premiums for individual market plans fell by 50 percent relative to national trends. The biggest surprise to me is that employer-sponsored health insurance actually went up after reform when it was falling everywhere else in the country.\"","status":"publish","parent":0,"modified":1326220301,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1246},"headData":{"title":"Great Subject for a Graphic Novel: Health Reform | KQED","description":"Michelle Andrews at Kaiser Health News features a Q&A today with MIT economist Jonathan Gruber, who hatched the idea to inform people about health care reform via a graphic novel.\r\n\r\nKey Takeaway? After health reform passed in Massachusetts, Gruber says, "Premiums for individual market plans fell by 50 percent relative to national trends. The biggest surprise to me is that employer-sponsored health insurance actually went up after reform when it was falling everywhere else in the country."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Great Subject for a Graphic Novel: Health Reform","datePublished":"2012-01-10T18:11:07.000Z","dateModified":"2012-01-10T18:31:41.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"1858 http://blogs.kqed.org/stateofhealth/?p=1858","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/01/10/great-subject-for-a-graphic-novel-health-reform/","disqusTitle":"Great Subject for a Graphic Novel: Health Reform","path":"/stateofhealth/1858/great-subject-for-a-graphic-novel-health-reform","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_1867\" class=\"wp-caption alignleft\" style=\"max-width: 210px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/GruberBookCover_FullRes.jpg\">\u003cimg class=\"size-medium wp-image-1867\" title=\"(Courtesy: Kaiser Health News)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/GruberBookCover_FullRes-300x427.jpg\" alt=\"(Courtesy: Kaiser Health News)\" width=\"210\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: Kaiser Health News)\u003c/figcaption>\u003c/figure>\n\u003cp>Michelle Andrews at \u003ca title=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2012/health-law-graphic-comic-book-Michelle-Andrews-Gruber.aspx\" href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2012/health-law-graphic-comic-book-Michelle-Andrews-Gruber.aspx\" target=\"_blank\">Kaiser Health News\u003c/a> features a Q&A today with MIT economist \u003ca title=\"http://econ-www.mit.edu/faculty/gruberj/shortbio\" href=\"http://econ-www.mit.edu/faculty/gruberj/shortbio\" target=\"_blank\">Jonathan Gruber,\u003c/a> who hatched the idea to inform people about health care reform via a graphic novel.\u003c/p>\n\u003cp>Key Takeaway? After health reform passed in Massachusetts, Gruber says, \"Premiums for individual market plans fell by 50 percent relative to national trends. The biggest surprise to me is that employer-sponsored health insurance actually went up after reform when it was falling everywhere else in the country.\"\u003c/p>\n\u003cdiv>\n\u003cp>No kidding. In California, employers offering health insurance fell from 73 percent to 63 percent in the last two years, according to a \u003ca title=\"http://www.chcf.org/publications/2011/12/employer-health-benefits\" href=\"http://www.chcf.org/publications/2011/12/employer-health-benefits\" target=\"_blank\">study\u003c/a> released just last week.\u003c/p>\n\u003cp>Here's Andrews complete story:\u003c/p>\n\u003cp>Nearly two years after the passage of the federal health law, more than 40 percent of people say they know little or nothing about how the law will affect them, according to the Kaiser Family Foundation's latest \u003ca title=\"http://www.kff.org/kaiserpolls/upload/8265-F.pdf\" href=\"http://www.kff.org/kaiserpolls/upload/8265-F.pdf\" target=\"_blank\">poll\u003c/a>. That figure hasn't budged since April 2010, just after the law was signed.\u003c!--more-->Jonathan Gruber, an economist at the Massachusetts Institute of Technology, aims to change that with a book, \u003ca title=\"http://us.macmillan.com/healthcarereform/JonathanGruber\" href=\"http://us.macmillan.com/healthcarereform/JonathanGruber\" target=\"_blank\">\"Health Care Reform: What It Is, Why It's Necessary, How It Works\u003c/a>.\" It explains the ins and outs of the law in an innovative way: an adult comic-strip form similar to graphic novels.\u003c/p>\n\u003cdiv>\n\u003cp>Gruber was one of the architects of the Massachusetts' health care overhaul, which included many features that appear in the federal law, and he advised the Obama administration and Congress on the Affordable Care Act. I spoke with him about his new book, which he co-authored with HP Newquist. The book is illustrated by Nathan Schreiber.\u003c/p>\n\u003cp>\u003cstrong>Q. What made you decide to write a book for consumers about health reform?\u003c/strong>\u003c/p>\n\u003cp>A. I think what really inspired me was hearing that when you polled consumers about the Affordable Care Act they were split in their support. But when you polled them about individual pieces of the law, they liked it. As an educator, you didn't have to do any more than explain what the law did [to gain support]. It needed to be explained in a way that people understood.\u003c/p>\n\u003cp>\u003cstrong>Q. Why did you choose a graphic novel format?\u003c/strong>\u003c/p>\n\u003cp>A. The publisher approached me about doing it that way. At first I wasn't that enthusiastic. I didn’t think it would be that effective. But the publisher said they had done a graphic novel about the \u003ca title=\"http://us.macmillan.com/the911report-1/SidJacobson\" href=\"http://us.macmillan.com/the911report-1/SidJacobson\" target=\"_blank\">9/11 Report\u003c/a>. My son likes graphic novels, he's 17. He said it's a great opportunity, it's a great medium. When you're on a plane and they want to teach you what to do in case of accident, they hand you a graphic. I think it was the right call.\u003c/p>\n\u003cp>\u003cstrong>Q. Who's the primary audience for this book?\u003c/strong>\u003c/p>\n\u003cp>A. I wrote it for the person who is confused and open-minded about this bill. The person who doesn't understand it. The two groups I really hope will read it and benefit from it are the independent voter who was inclined to like Obama and knows it's a big, transformative bill and wants to learn more, and the disaffected Democratic voter. I'm stunned that many don't support it.\u003c/p>\n\u003cp>\u003cstrong>Q. Do you think it will change any minds? Turn opponents into supporters?\u003c/strong>\u003c/p>\n\u003cp>A. I don't think it's going to change the minds of anyone who's convinced it's a bad piece of legislation. But it could change the minds of those who are wary and concerned.\u003c/p>\n\u003cp>\u003cstrong>Q. You showcase Massachusetts as an example of how health reform can work, noting that it employs some of the same elements that appear in the federal law, like the individual mandate that requires people to have insurance. What should readers be aware of about Massachusetts' experience with health reform? Has anything surprised you?\u003c/strong>\u003c/p>\n\u003cp>A. I would say the point the book tries to make is that Massachusetts was successful in what it tried to do. It reduced the number of uninsured and lowered non-group insurance premiums. Premiums for individual market plans fell by 50 percent relative to national trends. The biggest surprise to me is that employer-sponsored health insurance actually went up after reform when it was falling everywhere else in the country. It speaks to the power of the [individual] mandate. People said, \"Give me health insurance,\" and they did.\u003c/p>\n\u003cp>\u003cstrong>Q. You talk about how health care reform will help Anthony, Betty, Carlos and Dinah, all of whom have different health insurance situations. But you don’t discuss what will happen to Emilio the undocumented worker, who won't get coverage under the new law. Did you consider talking about who loses out under health reform, including the roughly \u003ca title=\"http://www.pewhispanic.org/2011/02/01/unauthorized-immigrant-population-brnational-and-state-trends-2010/\" href=\"http://www.pewhispanic.org/2011/02/01/unauthorized-immigrant-population-brnational-and-state-trends-2010/\" target=\"_blank\">11 million\u003c/a> illegal immigrants?\u003c/strong>\u003c/p>\n\u003cp>A. You hit on a great issue: Who loses out under the law. People don't lose out. Emilio doesn't lose out, he just doesn't gain. A lot of people don't gain. By design, the bill leaves a lot of people alone, including those with employer-sponsored insurance. They don't lose but they don't gain either. As for undocumented immigrants, there was no support to help them. Unfortunately, the law leaves them out in the cold. That was just a political reality.\u003c/p>\n\u003cp>\u003cstrong>Q. I know it's a big piece of legislation and you were trying to cover a lot of ground, but I couldn’t help thinking as I read the book that in some places you oversimplified in such a way that it made the law look better than it is. Can you talk a bit about concerns some may have that you may confuse readers by making sweeping statements about the benefits of this law?\u003c/strong>\u003c/p>\n\u003cp>A. Certainly I wrestled a lot with where to simplify and where not to. I think I tried my best to never be misleading. At the end of the book there's a set of references where people can go to learn more about the law. I think the truth is that most people don't want that level of detail. It's for people who just want to know what the heck is this bill.\u003c/p>\n\u003cp>\u003cstrong>Q. In the book you discuss the long-term care program created under the law, the CLASS Act, which the administration has decided not to implement, at least not at this time. Obviously, this law is changing and evolving. Depending on what happens in the next election, it could change a lot. What do you think is going to happen? Do you have any plans to update the book?\u003c/strong>\u003c/p>\n\u003cp>A. I am fairly confident, I think there's a better than 50 percent chance, for the Supreme Court not to turn down the mandate, and voters not to kick Obama out of office. If both those things go that way, I think it will be an incredibly positive thing for the Democrats in 2016. It will be good for them because the law will be doing good things by then. States need to move more quickly if we're going to implement the law smoothly. I can see it starting out roughly and being in great shape in a year or two.\u003c/p>\n\u003cp>My guess is I wouldn't want to update [the book]. I haven't really thought about that.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/1858/great-subject-for-a-graphic-novel-health-reform","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_41","stateofhealth_119"],"label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. 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