The High Stakes of the ACA

ACA Becomes LawA recent article in The New York Times features several Lincoln residents, among others, who have a lot to lose if the Affordable Care Act is struck down by the Supreme Court on Thursday.

Many insurance companies refuse to sell to those who have pre-existing conditions.  Pre-existing conditions can be anything from a chronic illness to an allergy you had years ago.  It just depends on the insurance company.  Insurers refuse to sell to people with pre-existing conditions because they assume that people with pre-existing conditions are more likely to have medical needs, meaning the insurer will have to pay more bills and risk their profit margin.  If an insurer refuses to sell to someone it forces them to remain uninsured, or if they do offer coverage, companies charge premiums that few can afford. For the working families, the middle class, and retirees not yet old enough to qualify for Medicare, that can mean the choice between life-saving treatment and putting food on the table.

The ACA created a new high-risk pool, however, where people with pre-existing conditions can purchase insurance at reasonable rates. And should the law be upheld, insurance companies will no longer be able to deny people coverage based on a pre-existing condition starting in 2014, nor will they be able to charge more on the basis of health status. That means that people like JoAnna Hanson, a working mother of three, won’t have to choose between having emergency surgery and feeding her kids. And it means that couples such as the Garlands won’t be faced with the choice between getting a divorce and getting life-saving cancer treatments.

As we await a decision from the Supreme Court tomorrow on the Affordable Care Act, it is worth clarifying once again, that the requirement that people buy insurance only applies to affordable coverage.  That is why the law also provides tax credits to help people pay for and afford insurance.  And it is why the law includes several exceptions to the requirement that you buy insurance.  One of the key policy decisions underlying the ACA is that people should not pay more than a certain amount of their yearly income to insurance coverage.  As the name implies, the law is focused on affordable coverage. So if you have to pay more than that to get insurance, you would not be required to buy insurance.  The Kaiser Family Foundation has an easy-to-follow chart on how that mandate works.

The purpose of the ACA is to provide quality, affordable coverage for everyone, especially those who are uninsured, and it’s already begun to do just that here in Nebraska.

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