Taking stock of Obama’s healthcare law and what it means for you
The White House is touting how the law has helped Latinos, but it faces a serious legal challenge before the Supreme Court next week. (Flickr: Envios)
By STEPHEN KEPPEL and JORDAN FABIAN
Channels: Economics, Politics
Friday marked the second anniversary of the passage of the Affordable Care Act, President Obama’s historic $1.1 trillion health care reform law designed to drastically overhaul the U.S. healthcare system.
The Affordable Care Act, dubbed “Obamacare” by its opponents, remains an extremely partisan issue (just check out the opinion pieces we published on Friday) but we wanted to take a closer look to see how the bill has already affected Latinos, the provisions that have yet to be implemented, and the serious challenges to the law’s future existence.
Two years after the law has passed, there is still not a whole lot of clarity on the complete impact of the law. The White House spent this week touting the impact the law has already had, but its major provisions have yet to be put into place and won’t be for another two years.
And next week, the Supreme Court will hold an unprecedented three-day deliberation over the law. On Tuesday, the Court will hear arguments on constitutionality of the bill’s central provision, the so-called “individual mandate” that requires each citizen to purchase health insurance or pay a fine.
A ruling is expected in June, which could decide whether the law survives.
How will the Affordable Care Act impact the Latino community?
Before we get to the politics here are a few facts and figures on the healthcare challenges facing the community:
* The law addresses a serious gap in healthcare coverage between Latinos and non-Latinos: A 2009 Gallup poll found that 41.7 percent of American Hispanics aged 18 and over lacked health insurance, compared to the national average of 16.0 percent, including 11.6 percent of white, non-Latino Americans.
* People with limited English proficiency and low-income individuals are less likely to have a regular source of primary care and receive preventive care.
* Latinos consistently rank healthcare as a top concern, just behind the economy and immigration.
Here’s how the law has already targeted these problems:
*It is now against the law to deny coverage to children with preexisting conditions.
*For those who have coverage now, preventive care is available without co-pays or co-insurance. This provision affects 6.1 million Latinos. According to the White House, 500,000 Latinos in the Medicare program have accessed preventive care within the last year.
*The Affordable Care Act removes lifetime limits for insurance coverage. This impacts 11.8 million Latinos, and is especially important for those with a chronic condition.
*2.5 million young adults (up to age 26) now have insurance coverage, including 736,000 Latinos, because they can stay on their parents’ plans.
But the major provisions of the law will not be implemented in 2014, including the controversial individual health insurance mandate. Here are some other provisions that have yet to be put into place:
* Medicaid will cover all adults with incomes up to 133 percent of the federal poverty level (roughly $14,400 for a single adult)—including those without dependent children.
* Health insurers will be prohibited from denying coverage on the basis of preexisting conditions or rescinding coverage when people get sick for all individuals, not just children.
* Those without health insurance will be able to purchase coverage through health insurance exchanges, with sliding scale subsidies for low- and moderate-income families.
The political battle
The healthcare law was perhaps the most politicized issue and both sides are out in full force this week.
The White House dispatched a team of advisers to tout the impact of the law and Obama’s reelection campaign also blasted out promotional materials last week championing its effects.
“We now have evidence that costs have begun to come down and the point of the mandate is to make sure we can keep costs down. Because if you have a system in which only people who are sick are seeking insurance, that’s what drives costs up,” White House Domestic Policy Council chair Cecilia Muñoz told members of the Hispanic press during a briefing this week. “If you make sure that everybody participates, then that brings costs down. This law was designed to bring the cost curve down and expand access to healthcare.”
But the law’s opponents noted that Obama himself did not speak publicly about the healthcare act on its second anniversary, which they say is a sign that the president can’t campaign on his signature achievement due to the law’s flagging popularity among the general public. Top Republicans, such as presidential candidate Mitt Romney, spent the week pledging to repeal the law if elected to the White House.
Jennifer Sevilla-Korn, executive director of the conservative Hispanic Leadership Network, told Univision News that the Affordable Care Act “is going to damage healthcare for every American. It creates one size fits all program for everyone nationally. It doesn’t solve the cost problem.”
According to Sevilla-Korn, “This law would bankrupt the country.”
The American public is split on the issue with 45 percent in favor and 44 percent against, according to Gallup. Latinos favor keeping the law 50-29 percent, according to an October Latino Decisions poll, but close to 60 percent of Latinos are against the individual mandate, in part because they are worried it will cost too much to buy insurance.
Part of the reason that there is so much confusion and fear about “Obamacare” is that no one can really predict exactly how it will change our current healthcare system since most of the bill’s policies won’t be implemented until 2014.
In the meantime the rhetoric has taken on a life of its own (remember “death panels”?), which the White House blames for the middling popularity of the law.
“During the congressional debate, we saw a lot of intensity, a lot of overheating rhetoric and a lot of stuff that was flatly not true. Some of that is still continuing. … It’s not easy to discern the truth because you have to fight through layers of shouting in order to get there,” said Muñoz.
“I think the debate in general has had maybe more heat than light,” she added. “There is still a lot of exaggeration out there that makes it harder for people to understand.”
The biggest remaining hurdle to the bill’s implementation is the Supreme Court ruling. Conservatives believe they have a compelling legal case against the individual mandate, which they argue violates the commerce clause of the U.S. Constitution (for more on that, read here). But the White House is confident that the mandate abides by the law.
“Ultimately we believe the Supreme Court is going to uphold the law. And we are — the administration is going full steam ahead on the implementation of this law. Obviously, a number of its provisions are already in place, there are a number still to go,” said Muñoz.
Republicans in Congress have also tried to chip away at the law through legislative means. Just this week, the House voted to dismantle a Medicare cost-control board established by the law. The provision has little chance of passing through a divided Congress and if it did, Obama would veto such attempts.
The administration says it will continue implementation through the Supreme Court hearing and the other challenges to the law because a lot of work remains to be done to set up its complex components, such as the insurance exchanges.
Once the Supreme Court case is past and the threat of repeal dies down, “there will be much less of a sense of uncertainty about it,” Muñoz said. “This law will be implemented, and it will have a positive effect on the country.”
