By Harry Kelber | LaborTalk (252) | June 30, 2012

The U.S. Supreme Court upheld President Barack Obama’s health care law, saying that its requirement that Americans obtain health insurance or pay a penalty was within Congress’s power to levy taxes. The vote was. 5 to 4, with Chief Justice John C. Roberts Jr. joining the four more liberal members.

Unions were pleased with the decision, because it safeguarded three important features of the Affordable Care Act; (1) that insurers could not reject people with pre-existing health disabilities; (2) children living with insured parents would be covered until age 26, and (3) low-cost prescription drugs would be available to retirees.

What remained particularly troublesome was how to provide health-care coverage for some 33 million uninsured people and who was to pay the cost, and how would the health insurance coverage be distributed.

Back in 2010, the Obama team expected Congress would pay the bill, but the Republicans balked, saying the cost must be offset by further spending cuts. The Republicans and their conservative allies are determined to oppose every Obama initiative with their overall goal to deny Obama a second term as the occupant of the White House.

Obama’s original mandate for people to buy insurance or pay a rising penalty created new hardships for the low-income families and the poor, who can not afford to buy insurance or pay the penalty.

How Will the 33 Million Get Health-Care Coverage?

The latest scheme is to put the burden of financing the health insurance plan on each of the states, through the expansion of Medicaid. But many states, especially those run by Republicans, refuse to take on this task, even with generous subsidies from the federal government. Moreover, Medicaid will have its funds sharply cut at a time when its services are bound to increase and become more costly.

So we are back to the original, overall problem: who is going to pay for the Affordable Care Act? Who will administer it? How many people will it benefit?

It is amazing how most people do not understand the complexities of the Affordable Care Act, even after two years since 2010, when it was passed. They do not realize that unless they have health insurance coverage by 2014, they will have to pay a penalty of $95 or 1 percent of their taxi income, and that the penalty could rise progressively to as much as $2,085 per family if the fine is not repaid by 2020.

Understandably, people want to know how the Supreme Court ruling affects their own insurance plan, in terms of costs and benefits. Some of the answers are speculative. A lot will depend on what Congress approves, rejects or ignores in the new health care law.

The AFL-CIO Looks at the Future of the Health-Care Law

In a statement shortly after the Supreme Court’s decision, AFL-CIO President Richard Trumka said: "We are pleased and relieved that the Supreme Court has upheld the constitutionality of the Affordable Care Act, Today’s decision means that we can continue moving full-speed ahead to implement and build upon the Affordable Care Act.

"The Affordable Care Act is our first step in expanding health-care coverage, improving care and beginning to get control of health care costs. A simple constitutional change would allow Americans of all ages to buy into an improved Medicare program."

Trumka’s current position on health insurance comes fairly close to the single-payer, universal coverage, endorsed by 21 international unions and hundreds of local labor organizations.

President Obama is to be commended for his courage in initiating the Affordable Care Act. It may takes months, probably longer, for the newly-elected 113rd Congress to clarify the inbedded intricacies of the health legislation, but it is work that our nation must undertake.

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