1) the coverage ceiling insurance companies placed on our care was tossed
2) pre existing conditions is no longer something that precludes me from getting coverage
3) that the cost of women's premiums are being levelled (because we go to docs more, our rates were higher)
4) that my great niece and nephew and be on their mom and dad's plans while they're working their way through college. My nephew works full time and goes to school, he has since he was 13 and has had his share of farm accidents.
If the mandate is tossed, well, look at the article. This effects us.
You bring up some excellent points as to why our community needs to be concerned about the possible Supreme Court's actions. From a personal perspective, I have benefited from my husband's insurance companies removal of the $1M lifetime cap and the allowance of my son's to be on his policy until 26 years of age.
Most of us don't realize we are one job loss, one divorce, one healthcare crisis from being uninsurable. I realize how silly it is to have to rely on an employer for healthcare coverage. We may be one of the only developed nations not to have a single payer system. I'm very concerned and scared that the supreme court will overturn these provisions and then I could potentially be between a rock and a hard place as far as getting insurance coverage.
I've heard so many stories by women that were diagnosed with bc and can no longer get insurance. One recently is a 4 year survivor and applied for insurance with her family. She was denied coverage because of her preexisting condition. Now if this was 2014, she would no longer be denied coverage. As of now, her only choice is to hopefully be allowed into her state's insurance pool.
Donna, did you watch Fareed's segment on Sunday? I saw it 2 times and would see it a third, thanks so much for bringing it up, I have to think everyone would benefit from seeing it. It's all complicated but it would seem the US is already behind compared to the developed countries. It's all about access!
Thanks, Donna. I wanted to watch this, but unfortunately missed it. I hope the new reforms will be turn out to be helpful, but it makes me nervous when in the video at the top of the link Fareed says that in America "We fight death. Other societies at some point accept it." This line of reasoning could potentially put those with an unusual, expensive, and difficult to treat disease like TNBC at risk. I guess we'll have to wait and see what it all means and hope for the best.
In 2006, our daughter was dropped from our health insurance at midnight on the day she graduated from college. I am so in favor of the provision in the new health care law that will prevent this from happening to others. And, Donna, I certainly understand your point--if my husband lost his job, neither one of us would be insurable now due to pre-existing conditions. When I hear politicians state that their first priority is to get rid of "Obamacare," I don't understand why the interviewers don't ask them about some of the more popular provisions that it includes.
Martin & Charlene, please read the link that I provided. If the Supremes go ahead and hear the arguments next week and, as the article says we have had 2 lower courts vote to uphold the mandate and 1 to toss it, then a thumbs down on & the mandate would be compromised and our new reforms TOAST!
Remember, the Roberts' Court is a Conservative held bench, with even Judge Thomas' wife a TParty member who has run rallys against HealthCare.
Our cover story focuses on how the Affordable Care Act impacts you as a woman diagnosed with breast cancer. Explore the current health system; changes happening now and in the future; provisions of the law that apply to women diagnosed with breast cancer; and where to get more information as the healthcare system changes.
June 28, 2012 — The Supreme Court today declared in a 5-4 vote that
the Affordable Care Act (ACA) — the most significant healthcare
legislation since the creation of Medicare — is also a constitutional
act.
The ruling comes as a shock to many observers, who predicted the
court would strike down the individual mandate to obtain insurance
coverage, if not the entire law, after its 5-member conservative wing
voiced misgivings about the controversial provision during oral arguments
in March. The court decision also represents an early Christmas present
for President Barack Obama, who seeks reelection this fall against a
Republican opponent committed to rolling back "Obamacare."
The individual mandate was at the core of a lawsuit filed against the
ACA by officials from 26 states, all but 1 of whom were Republican, as
well as a business association. Similar to their Republican allies in
Congress, the plaintiffs claimed that the mandate violated the
Constitution's Commerce clause, which empowers Congress to regulate
interstate commerce. They argued that although healthcare is a form of
interstate commerce, Congress cannot compel "inactive" individuals to
engage in commerce; that is, to buy or sell something. To allow the
mandate to stand, they said, would open the door to further
encroachments on personal liberty.
A federal district court in Florida and a federal appeals court
in Georgia sided with the plaintiffs and invalidated the individual
mandate. However, the Supreme Court had other precedents to follow.
The majority of lower federal courts that ruled on similar challenges
to the ACA gave the mandate a clean bill of health, agreeing with the
Obama administration's argument that contrary to the law's critics,
individuals foregoing insurance coverage actively participate in the
healthcare marketplace because they will eventually require medical
attention. Their decision not to get coverage is bad for everyone else
because the cost of their free or subsidized care is passed on to others
in the form of higher provider costs and higher premiums, according to
the administration. In addition, the decision by healthy Americans to go
uninsured leaves the existing risk pool of insured Americans smaller
and sicker, driving up premiums even more.
The mandate helps cure all these problems, the administration
contended, by forcing "free riders" to finance their healthcare now as
opposed to later, if at all.
During the oral arguments in March, several conservative Supreme
Court justices did not appear to buy into the administration's point of
view.
"Here the government is saying that the federal government has a duty
to tell the individual citizen that it must act," said Justice Anthony
Kennedy, "and that is different from what we have in previous cases, and
that changes the relationship of the federal government to the
individual in a very fundamental way."
The court's ruling on the ACA addressed more than the mandate. The justices also upheld the constitutionality of the law's dramatic expansion of the Medicaid program, which the plaintiffs had portrayed as a usurpation of states' rights. The court also declared that a penalty levied
on individuals who fail to obtain health insurance coverage beginning
in 2014 does not bar consideration of the case beforehand. At issue was a
law called the Anti-Injunction Act (AIA), which prohibits anyone from
challenging a tax in court until it has been paid. A federal district
judge in Richmond, Virginia, last year ruled that the ACA penalty
amounted to a tax, and thus triggered the AIA.
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15
(CNN) -- The Supreme Court's decision Thursday to
uphold the Affordable Care Act means that the predictions about how it
will affect all Americans remain in place.
The decision leaves in
place the so-called individual mandate -- the requirement on Americans
to have or buy health insurance beginning in 2014 or face a penalty --
although many are exempt from that provision.
In 2014, the penalty will
be $285 per family or 1% of income, whichever is greater. By 2016, it
goes up to $2,085 per family or 2.5% of income.
Ruling on individual mandate explained
Photos: Health care and the high court
Health care exchanges, which are designed to offer cheaper health care plans, remain in place as well.
The insured
Because the requirement
remains for people to have or buy insurance, the revenue stream designed
to help pay for the law remains in place. So insured Americans may be
avoiding a spike in premiums that could have resulted if the high court
had tossed out the individual mandate but left other requirements on
insurers in place.
Young adults
Millions of young adults up to age 26 who have gained health insurance due
to the law will be able to keep it. The law requires insurers to cover
the children of those they insure up to age 26. About 2.5 million young
adults from age 19 to 25 obtained health coverage as a result of the
Affordable Care Act, according to the U.S. Department of Health and
Human Services.
Two of the nation's
largest insurers, United Healthcare and Humana, recently announced they
would voluntarily maintain some aspects of health care reform, including
coverage of adult dependents up to age 26, even if the law was
scrapped.
People with pre-existing conditions
Since the law remains in place, the requirement that insurers cover people with pre-existing medical conditions remains active.
The law also established
that children under the age of 19 could no longer have limited benefits
or be denied benefits because they had a pre-existing condition.
Starting in 2014, the law makes it illegal for any health insurance plan to use pre-existing conditions to exclude, limit or set unrealistic rates on coverage.
It also established
national high-risk pools that people with such conditions could join
sooner to get health insurance. As of April, a total of only about
67,000 people were enrolled in federally-funded pools established by the
health care law, according to the National Conference of State Legislatures.
More than 13 million
American non-elderly adults have been denied insurance specifically
because of their medical conditions, according to the Commonwealth Fund.
The Kaiser Family Foundation says 21% of people who apply for health
insurance on their own get turned down, are charged a higher price, or
offered a plan that excludes coverage for their pre-existing condition.
All taxpayers
No matter what the
Supreme Court had decided, it would have been a mixed bag for all
Americans when it comes to federal spending. There is heated dispute over what impact the health care law will have on the country over the long term.
The federal government is set to spend more than $1 trillion
over the next decade to subsidize coverage and expand eligibility for
Medicaid. The nonpartisan Congressional Budget Office estimated that the
law could reduce deficits modestly in the first 10 years and then much
more significantly in the second decade.
The CBO said a repeal of
the mandate could reduce deficits by $282 billion over 10 years,
because the government would be subsidizing insurance for fewer people.
But the nation faces costs in various ways for having people who are
uninsured. The Urban Institute's Health Policy Center estimated that without a mandate, 40 million Americans would remain uninsured.
Meanwhile, the Flexible
Spending Accounts that millions of Americans use to save money tax-free
for medical expenses will be sliced under the law. FSAs often allow
people to put aside up to $5,000 pre-tax; as of 2013, they were to face
an annual limit of $2,500.
Small business owners
The rules and benefits small business owners face as a result of the health care law remain in place.
As CNN has chronicled, the law brought a mix of both. The director of the National Federation of Independent Business is one of the plaintiffs who pushed the court to strike down the law. Meanwhile, a group called Small Business Majority fought to protect the law, saying its loss could be a nightmare.
As of 2014, under the law, small firms with more than 50 full-time employees would have to provide coverage or face expensive fines.
All Americans, in lesser known ways
The massive health care
law requires doctors to report goodies they get from medical supply
companies; demands more breastfeeding rooms; requires all chain
restaurants to list calories under every menu item, and includes numerous other provisions, which now remain in place.
Doctors and other health care providers
Health care providers
have already begun making changes based on the 2010 law, and in
preparation for what will go into effect in 2014. Those plans continue.
In the short term,
doctors avoid "chaos" that may have resulted from the law suddenly being
dropped or changed, according to Bob Doherty, senior vice president of
governmental affairs at the American College of Physicians, who wrote a blog post on the website kevinmd.com this spring.
I feel like I can breathe for the first time in months! Such good news. And since the US is 37th in health care globally maybe this will become a turning point for us to climb back to the top again.
To my dear sisters who are happy about the decision of the Supreme Court today, I pray that in 10 years you will still be happy with this decision. There are some of us who are not happy about what is happening in our country. I don't want government coming between me and my doctors and making the decisions about my healthcare.
That being said, I would hope that we could keep politics out of this forum and remember the ultimate purpose for this forum which is to share and encourage each other.
Love & hugs, Genie
DX 3/10/08 at age 67, IDC. Stage 1, Grade 3, 1.5 cm. KI-67 99% at MX . Bilateral mastectomy 4/1/08 Node-, BRCA 1/2-,BARD1+, TX:Cytoxan/Taxotere x4,3 in family with TNBC
You are so important to me! Your love and caring of all of us has meant the world to me during times of need. So it's also important to me for you to feel comfortable with this discussion.
The plan is ABSOLUTELY meant to keep your relationship with your doctors and team intact and in many ways it actually reinforces that relationship with you. You and your doctors will remain in total control of your healthcare issues, the myth that the govt will intervene is a terrifying one, but it is just that...a myth. It's important to understand the role of money here. The HealthCare advocates have been outspent 16:1 by the anti health care side.
As far as politics are concerned, I understand. That said, I believe in you and your ability to analyze facts for yourself and facts are what will keep this discussion about our health and survival and what tools are now ours to make that chance our reality.
"We fight death. Other societies at some point accept it." This line of reasoning could potentially put those with an unusual, expensive, and difficult to treat disease like TNBC at risk. I guess we'll have to wait and see what it all means and hope for the best. (per Martin's post above)
Dear Martin and All....
It is my understanding that "Accepting death, and not fighting it" puts older adults at risk. It doesn't have to be TNBC. For instance, who will get their stints first?.... The 55 yr. old or the 70 yr. old. And our state of health will not be the primary factor.... (Scary!!!)
Also, when our 2 children finished college we purchased an individual BC & BS health policy to cover them until they were employed and on their own.
I'm with Genie about the politics and Breast Cancer Support.
God Bless,
Lillie
Edited by Lillie - Jun 28 2012 at 7:37pm
Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED
Lillie dear, please read the articles that Donna posted as well as the AARP article I posted. The Health Care Act does NOT have death panels. That is a myth. Please please know that there is no rationing, please please read at least the AARP. It breaks my heart to think that you may have even a minute of anger or fear over this.
We love you on this forum and all you do to contribute and help others. My elation has nothing to do with politics, it's just very personal to me. My health insurance is tied to my husband's employer. They used to have a $1M lifetime cap (until they had to change it with the law). We've been married for over 30 years and this limit has been in place. I bet with all my treatment so far, I'm halfway there to that $1M number. It scares me with the cost of healthcare today and how easily you can reach the limit. The other worry, is what happens if my husband lost his job? We couldn't afford COBRA and I have a preexisting condition and would not have insurance. Could he get insurance? What if he divorced me? How could I get or afford insurance. How would I pay for my treatments? Too many worries for someone to deal with while going through treatment.
My sister-in-law is going through a divorce after being married 30 plus years. She'll lose her health insurance through her husband's employer and can't afford COBRA either. She's also worried at her age if she could get affordable coverage or just go without insurance. She's made the comment to me that I guess I won't have health insurance, hope I don't get sick.
I would never bring politics into this forum. It has no place here. What I want is all of us to have access to affordable healthcare. I've talked to too many women on other forums that have had to file bankruptcy, lose their house, their life saving, retirement, etc. because of the cost of their cancer treatment. I was extremely healthy until I was 49 and diagnosed with cancer. I took our healthcare coverage for granted.
Hugs, Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09) 11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15
Dear Mainly & Donna, I didn't mean to start anything by my post. Shall we agree to disagree? I have read the info on the links and many other sites concerning the Obamacare. I've also discussed this issue with my doctors. Just last week my oncologist informed me that for the first time in 20 years, her practice lost money and she had to let 3 people go. This loss is a direct result of the interference from the government she stated and as more of Obamacare is instituted, she is not sure to will be able to keep her practice open. She told me that if she doesn't write 10 escripts a year, the government takes 1 % of her yearly income as a penalty. This is just wrong!
I agree that changes need to be made in our health care but I don't think government should force everyone to have insurance. My daughter and her husband can barely make ends meet and I sure don't know where they would be able to come up with the additional money for health insurance. They don't qualify for any assistance so we pay for any medical care they receive.
I love and respect you all. Genie
DX 3/10/08 at age 67, IDC. Stage 1, Grade 3, 1.5 cm. KI-67 99% at MX . Bilateral mastectomy 4/1/08 Node-, BRCA 1/2-,BARD1+, TX:Cytoxan/Taxotere x4,3 in family with TNBC
Genie, just to help out, you know about the assistance that the program will be giving to cover insurance coverage if one finds the premiums too much of a challenge? That will be instituted early 2013.
Your doctor's story is profoundly devastating. I'm going to look into that as I agree that that kind of experience is just wrong.
*Update* I think I found what your doctor was referring to and it is a Medicare situation where the doctors can get a bonus if they participate or are fined if they don't. http://www.ama-assn.org/amednews/2012/05/28/gvl10528.htm This is not part of the Health Care Reform Act, but certainly I can understand the concern.
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