|By Patricia Anstett and Robin Erb, Detroit Free Press|
Sferlazza, 54, a disabled
Last year, Sferlazza finally got coverage through a provision of the Obama administration's Affordable Care Act, which helps create temporary insurance plans for high-risk people through 2014, when broader reforms are set to take place.
The plan paid for surgery, physical therapy, medicine and doctor visits that have helped Sferlazza stop using a cane and pain drugs, she said last week.
"Without health reform, I'll be uninsurable again," said Sferlazza, whom the
The court is expected to rule on the future of the Affordable Care Act -- one of the biggest expansions of national health coverage since the creation of the federal
The new law would require most Americans to have health insurance or pay a tax penalty, beginning in 2014, and would greatly expand
A national business organization and 26 attorneys general, including
"This is the first time ever in our nation's history that the federal government would force every citizen to purchase a product," Schuette said Friday in an interview. He said it may sound farfetched, but if the federal government can force people to buy health insurance, it also could require people to buy
Though the nation clearly needs to debate how to improve health care, "it needs to be done in a constitutional fashion," he said.
If the justices strike down the requirement to buy insurance, experts say it could cause an avalanche that would undo other provisions.
The mandate provides the "financial underpinnings" of the entire law, said
The Obama administration has asked the court, if it declares the mandate unconstitutional, to also overturn related provisions that require insurers to accept and cover people with pre-existing conditions at no higher cost.
If the pre-existing conditions provision is struck down, "I'll be back to square one," Sferlazza said.
The court's widely anticipated decision could take several forms. It could throw out the whole law, keep it or overturn some of its parts.
Experts are divided over what will happen if the court throws out the mandate but keeps intact the requirements that insurers accept all applicants and charge them the same as others.
The insurance industry predicts big hikes in insurance premiums and more uninsured people. Five different studies analyzed by
By contrast, the
The variations show just how much of a guessing game it may be if some parts of the law are ruled unconstitutional.
Experts say many popular reforms will stay. Three large insurers --
The ability of his oldest daughter, Erin, to be covered by his policy for a year "was huge," said
When she turned 26 this year, she had to replace the coverage with a student insurance policy that costs her
"Will there be a job when he graduates?" Katz asked. "Knowing he'll have health insurance through me is very helpful."
Whatever the court's decision, political wrangling will continue as new members of
Much at stake in state
With 1.1 million uninsured people and declining numbers of employers providing insurance, particularly to new workers,
The Republican-dominated Legislature last year refused nearly
A deadline to apply for additional federal money for the exchange comes Friday, though the federal government soon will announce other opportunities for states to get funds, according to a spokesman for the
States face a
Overall, Americans slightly oppose the entire health reform law, by a 51%-43% margin, though 1 in 6 opposes it because the law doesn't go far enough, according to polls conducted as recently as late May.
The law has been blasted by religious groups opposed to a provision that requires health plans to offer contraceptive services.
"They are taking our religious freedoms away and demanding that our religious institutions pay for abortions," said
"I'd rather see the
An HHS official reiterated Friday that the law does not cover abortions or RU-486, the so-called abortion pill.
In February, the Obama administration passed a new policy it said it hoped would appease concerns. The new rules will require insurers to provide contraception benefits to women, but it exempts faith-based organizations from having to share in that cost for their employees.
Divisions arise early
The health care law, adopted in 2010, became divisive early on, with tea party and other opponents swarming public meetings.
Dubbed Obamacare, the law has become one of the biggest issues in this fall's presidential and other races. Republican nominee
But provisions of the law continued to click into place as recently as last week, such as the new money Sebelius announced for six
Other parts of the law benefit health care, health industry experts say, and are very likely to stay, including measures to improve hospital care and patient safety and to make the complicated world of health insurance more understandable.
"It doesn't matter what the
Arylssa Heard, a
Heard, who is unemployed and uninsured, pays
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