For Tracy Heiman the Affordable Care Act has brought peace of mind. She has a young son with a rare cancer and now she knows that down the road insurance companies cannot deny the family coverage because of his preexisting condition.
The health care law prohibits insurers from excluding coverage for children with pre-existing health conditions. In 2014 the bill will also prohibit insurers from excluding adults with preexisting conditions.
"His cancer is called chronic care. I spent years working on the issue of making sure kids aren't denied insurance just because they have a preexisting condition. Since the law went into effect I've been able to concentrate on other things such as working on the issue of cancer awareness," Heiman says.
Heiman's family currently has good insurance through her husband's job. But for years they worried, afraid if her husband had to change jobs there might not be insurance for their son.
"We are free to look for work at other companies or find work if we lose it because my son won't be discriminated upon with chronic cancer condition. That is a big sense of relief for our family."
-- Ariane DeVogue
Elaine Cornett feels the same relief. Her daughter has type one diabetes. Although they currently have health insurance they were worried for their future.
"If the entire health care law is struck down, if my husband should lose his job, or a wonderful opportunity were to come up that would mean a shift of insurance we would have to think seriously about whether we could pursue the move or a new job."
She says, "it was a huge relief that I heaved when it was signed into law. It means for us we have more flexibility, we are lucky right now our coverage is good, but if anything changed it would be an enormous financial burden if we weren't able to get coverage."
-- Ariane DeVogue
Samantha Ames is grateful for another provision of the law currently in effect, which allows dependent children up to the age of 26 to stay on their parents' family policy. Between graduating from college and beginning law school Ames was uninsured. She lived without medication for nine months and was fearful that any little accident could ruin her life. After starting law school she took advantage of the student health plan. But then she fell and seriously re-injured an ankle. Ames suffers from loose joints and was told she needed major surgery to fix the problem to be able to walk properly. Had she stayed on the student plan her insurance would have cost from $5,000 to $12,000 in cost sharing. Under the Affordable Care Act she was able to join her parent's policy and have the surgery.
Now she worries that the Supreme Court will strike down the law. "My fear is that things will not only go back to how they used to be, but that there is such animosity in the air right now toward something that is a basic human necessity. "
-- Ariane DeVogue
The state of Washington is home to an awkward political pair: the governor, Chris Gregoire, and the attorney general, Rob McKenna.
One of them loves the health care law, and the other ... not so much.
McKenna, a Republican who is also running for governor, signed on to the effort among a bunch of states two years ago to challenge the constitutionality of President Obama's health care plan. To this day, Gregoire, one of Obama's closest allies among governors, complains that McKenna didn't consult her before making his decision.
But that's all old news. Reflecting on the past few years of acrimonious health care debate, Gregoire said in an interview that she knows many people won't see or feel the effects of the health law for years to come, but that Democrats need to improve on spreading the word.
In fact Gregoire said Democrats are to blame for every person who doesn't know that the law stops the ban on covering "preexisting conditions," lets young people stay on their parents' plan until they're 26, and does other things that the public generally supports in polling.
"Shame on all of us for not being able to communicate well with the public at large," Gregoire said.
Obama did nothing public on March 23 to mark the two-year anniversary of his signature legislation becoming a law. Many critics called attention to Obama's absence from the spotlight, though not all supporters were hiding — Gregoire, for example, was signing a health insurance law in her state intended to remind the public of the two-year measure.
She said she didn't think Obama should be staying away from the cameras, either.
"I would encourage everybody to be out there," she said.
A former lawyer, Gregoire predicts that the Supreme Court will uphold the law as constitutional and dismissed concerns that the so-called mandate unfairly requires people to buy health insurance. She compared it with rules that make people have car insurance or fire insurance on their homes, because, she said, if someone who doesn't have insurance needs to be covered, those who do have insurance wind up paying for it.
"Why isn't that the same reason when you go to the emergency room and you don't have any insurance? I'm paying for it," she said. "This is not unique."
Several Republican governors have halted the "implementation" of the health care law in their states and are seeking validation in the Supreme Court case that begins this week. The difference between those more conservative states and others that have embraced the plan highlights the clear divide that the law has drawn along party lines.
Pam Bondi, the attorney general of Florida who is among the challengers of the law, said last week that it amounts to a "complete over-reach by the federal government." In an interview on Fox News, Bondi said that the second day of debate, when they make their case for the mandate, is the "biggest part."
"We believe that we're in pretty good shape going into the court," Bondi said.
Gregoire said she has some sympathy for states that haven't adopted parts of the law yet.
"I feel sorry, frankly, for those states who have sat and done nothing, believing that the court's going to throw it all out," she said.
Gregoire's reliable support for the health care law has sparked conversation that she's gunning for a job in the administration after she leaves her post as governor. She said she had no answer to whether she would consider a job in Washington during Obama's second term — interior secretary? EPA director? — but acknowledged that she gets that question a lot.
She did say that plans on supporting Obama for a long time.
"I'll be willing to help him," Gregoire said. "In what capacity, I don't know."
-- Matt Negrin
Opponents of the law say it will be devastating for small businesses. Dan Danner, the CEO of the National Federation of Independent Business, a group challenging the law at the Supreme Court, says it has the potential to drastically change the private-sector job market as we know it.
It is the unknowns regarding associated with the law that concerns small business owners.
"The unknowns associated with the employer mandate have left many small-business owners trying to forecast how they will shift their workforce to avoid the financial penalties that will stem from offering "affordable" coverage, as defined by Congress, to their employees. It's really quite shocking how President Obama can tout the economic importance of small business in speeches across the country at the very same time that his healthcare law threatens the very jobs that small business creates, " says Danner.
"The health care law is financially devastating for small business," Danner said. "The employer mandate and health insurance tax will be job-killers, and have the potential to drastically change the private-sector job market as we know it. Our Research Foundation has projected that the private-sector job loss resulting from the health insurance tax could reach upwards of 249,000 jobs; small business will shoulder 59 percent of the jobs lost."
NFIB is confident that the law will be overturned by the Supreme Court, but until that time, we continue to fight against this harmful policy in Congress by leading the charge to repeal the employer mandate and the health insurance tax before it is too late."
-- Ariane DeVogue
Kurt Summers, a small business owner, hopes the court will strike down the law. Although he feels no impact from the provisions of the law currently in effect, he's worried about his planning for the future. He has 24 employees and added five last year and hopes to add six next year.
"As a small business owner the biggest impact is what we don't know. Quite honestly if the health care impact goes up another 20-30 percent I will have to rethink my hiring strategy. It's going to slow me down. "
His company, Austin Generator Service, installs generator systems for businesses and small homes.
Summers is no stranger to the controversy surrounding health care. Fifteen years ago his company had to stop providing major medical health insurance because of an economic downturn. "We had to face the decision: Do we provide jobs or go out of business?"
He says he considers his few employees like family. If he suffers another economic downturn he might have to eliminate insurance just to survive. It's not going to be good for my employees , but at least they'll have a job."
Summers' fears revolve around the unknown. He is not familiar with the ins and the outs of the law, but he's afraid of the government stepping in and hurting his business. "This is not big corporate America."
-- Ariane DeVogue