Supreme Court's decision on US healthcare act

[crimsonandclover]

I'm following a live blog at the moment that is analyzing the opinion and says that the bottom line is that it was upheld - including the individual mandate!

Anyone else following this right now? I have to say that I'm shocked. I never thought they would ok the individual mandate, but I am really excited and happy that they did. (Or is it only because it's considered a tax so it can't be challenged until someone actually has to pay the penalty for not having insurance? I know that's a possibility, but from the blog I'm following it sounds like that wasn't the decision.)

[crimsonandclover]

Ok, no, that was cleared up - the requirement for everyone to have health care was held up period. Not just put off for a later day.

[anna7602]

I'm going to a debate tonight where a bunch of Americans are going to sit around and analyze the issue from all sides. I reserve all opinions until then since I feel like I have only a hazy understanding of how this would work in practice.

Oh, yeah, and I'm using date night to do this, which is kind of a downer (no matter how nerdy I am), but at least DH came back from his work trip early.

[Deleted]

I am about to post and run - sorry about that BUT I realize that health insurance is in the best interest of the general public BUT I do not think it is the governments place to mandate that I have it.
I don't think it is the government's place to mandate anything about my healthy - be it having a sonogram before an abortion or having an abortion or requiring me to carry health insurance, or give my kid inoculations if I don't think it is necessary.

I think as big as people are making this out to be - it wasn't what healthcare needed at all. Healthcare is what we need not more health insurance.

I got my flame suit on. I'm ready for you!

[Deleted]

Quick question - that was it right - just that we're going to have to carry health insurance right? Is there anything else to the bill?

[elenetxu]

Has anyone got a good source explaining the whole issue? I've been out of the US so long I feel really lost.

Will this affect Americans living abroad?

[crimsonandclover]

To Hey Y'all - no, there was a lot of other things in the bill, but whether or not the individual mandate is constitutional was the major issue. If it is (which the SC found), then it didn't need to discuss the other provisions (except for one on Medicaid).

To elenextu - the only effect it could have on you directly is if you move back to the States and want to get insurance. Up until now, if you developed a condition while in Spain and then wanted to get insurance in the US, you might have lots of problems because they could deny you for having a pre-existing condition. Under the bill, children cannot be denied for a pre-existing condition and adults can't be starting in 2014.

Here's a pretty good overview of the more immediate effects (it's an article from 2010, but still relevant):
www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_508315.html#s75147&title=No_More_Denials

[elenetxu]

Thank you!

[crimsonandclover]

Ok, neeps, don't quote me on this because I'm not sure. I think the problem in the past is that people have been denied from getting insurance period because of pre-existing conditions, not just having that condition excluded. So how I understood the change is that they will be able to get insurance now, but I *think* (and that's a big think) that the insurance companies can still exclude the condition.

So in your example, you could get a policy to cover everything else, but you'd still have to cover your cancer-related stuff.

Again, I could be wrong on that.

[Deleted]

If the government can mandate that everyone have car insurance, then I don't see why they can't make people have health insurance.

I think the point isn't necessarily to FORCE people into getting insurance, it's to make healthcare and health insurance affordable enough that everyone IS ABLE TO have insurance and get the healthcare they need. And EVERYONE needs healthcare. In the US, taxpayers have been paying for the healthcare of the uninsured for years -- now everyone will be insured, so the overall cost to everyone should be less.

Having insurance doesn't mean you necessarily need to subject yourself to care or treatments that you don't want.

[GilliC]

So out of curiosity, what would happen if I was diagnosed with cancer or diabetes or something while I was living abroad? If they can exclude my pre-existing condition, does that mean that when I got back to the US I would have to pay a small fortune for insurance that covered my condition, or that I have to suck it up and pay out of pocket?

And even in the current system, does being diagnosed with something bad lock you into an insurance company for life, because any other company would charge outrageous amounts for your existing condition?

Sorry if these are dumb questions. I've always just assumed that I should be thankful for the crappy insurance plan offered by the company, because it was better than nothing at all. And I never really thought much about pre-existing conditions, because I didn't have to deal with them.

[popcorn]

Jun 29, 2012 6:33:01 GMT -5 @publius said:

Actually, I'm not sure how sweeping this is going to be given that the one bit of the bill that was thrown out was the incentive for states to inact it. IIRC, over half the state have said they won't be enacting it (which is what a handful of law suits were about) and now they don't have to because the provision stripping them of Medicaid funding if they don't is gone. I'd be surprised if this get implemented in half the country.

This is very interesting. I am always glad when you come and give your opinion because you know so much more about these kinds of things than I ever do.

I hadn't realized that.

[crimsonandclover]

Jun 29, 2012 6:38:06 GMT -5 @publius said:

Jun 29, 2012 4:30:33 GMT -5 GilliC said:

So out of curiosity, what would happen if I was diagnosed with cancer or diabetes or something while I was living abroad? If they can exclude my pre-existing condition, does that mean that when I got back to the US I would have to pay a small fortune for insurance that covered my condition, or that I have to suck it up and pay out of pocket?

And even in the current system, does being diagnosed with something bad lock you into an insurance company for life, because any other company would charge outrageous amounts for your existing condition?

Sorry if these are dumb questions. I've always just assumed that I should be thankful for the crappy insurance plan offered by the company, because it was better than nothing at all. And I never really thought much about pre-existing conditions, because I didn't have to deal with them.

Not dumb questions if you have health insurance while abroad (being covered by the national scheme of another country counts), and you don't have a break in coverage, the whole pre-existing condition thing is moot because you were diagnosed while covered by insurance. You don't have to have insurance in the US to fall under continuous coverage.

Exactly. If you have continuous coverage then it's not a problem, but any break in coverage could have disastrous consequences. One girl on a board I'm on described how she was diagnosed with a condition in college that caused her to have to become a part-time instead of a full-time student. That in turn would have dropped her from her parents' insurance. She was engaged at the time, so she and her fiance decided to move the wedding up as early as they could so she could be on her insurance, but there still would have been a break in coverage. Her parents paid almost $1000 / week from the time when her dad's insurance would have dropped her until the wedding so that she didn't lose coverage since the medication for her condition is extremely expensive. If she had lost coverage for even a day, no private insurance would have ever paid for it again. She said it cost way more for her parents to keep her health insurance for her than they paid for her wedding, but obviously she's extremely grateful.

And publius - you're completely right. So now we'll have this system in all the blue states and in very few of the red ones. I guess in a way it will be like a horrible controlled experiment where we get to see whether it works. Unless, of course, the uninsured in the red states move to the blue states just for health insurance (I would if I were them).

[crimsonandclover]

Here's a link that was posted on another board on TB that gives a great neutral overview of what the ACA does: www.reddit.com/tb/vbkfm

[crimsonandclover]

Jun 30, 2012 3:32:45 GMT -5 @publius said:

Jun 28, 2012 14:33:13 GMT -5 neeps said:

I really don't get what is to prevent me from simply paying the "tax" for not having insurance and when I'm diagnosed with cancer buying a policy at that time since I can't be denied for my pre-existing condition.

I don't get what's to stop people from not paying the tax since the IRS doesn't have the power the implement and collect it. There aren't going to be repercussions for not paying. The only way the government. An get the money is to take it out of your income tax refund, but if you've got your withholdings set up correctly, what can they do?

Could they fine you for tax evasion? Basically the SC just said they can't file criminal charges, but that doesn't mean they can't keep upping the fines for not paying, right?

It's probably very obvious from that statement that I have no legal education...