What does the health care ruling mean for me ... in English?

  • Obamacare supporters react to the U.S. Supreme Court decision to uphold President Obama's health care law, on June 28, 2012 in Washington, DC. Today the high court upheld the whole healthcare law of the Obama Administration.
Obamacare supporters react to the U.S. Supreme Court decision to uphold… (Getty Images )
June 28, 2012|From news services

In a win for President Obama, the Supreme Court narrowly upheld today the healthcare law nicknamed "Obamacare."

The decision was a 5-4 vote, with four justices who generally rule more liberally joining Chief JusticeJohn G. Roberts Jr.The Affordable Care Act says that people who don't have health insurance by 2014 will have to pay a tax penalty.

"The federal government does not have the power to order people to buy health insurance," Roberts wrote in the majority opinion, but "the federal government does have the power to impose a tax on those without health insurance."

The Affordable Care Act, a 2,700-page piece of legislation signed by Obama on March 23, 2010, sought to bring health insurance to more than 30 million uninsured people in the country.

But what does the Supreme Court ruling mean to the average person?

The answer is, several things, at different points in the process of implementing the law. Some of the parts of the law, like the tax penalty for not having health insurance, take effect in 2014.

Starting in 2014, a health insurance company can't deny coverage to someone because of a so-called "pre-existing" medical condition. They also won't be able to charge people more because of their gender, age or health status. Preventive healthcare like cancer screenings will be available without deductibles or co-pays.

There also will be healthcare "exchanges," where people from the same state can join and buy health care as a group. It will be cheaper than buying health insurance on your own, and the costs of premiums will be subsidized depending on how much money you make a year.

One of the other key parts of the Affordable Care Act is that people who don't have health insurance at work can stay on their parents' plans until their 26th birthday. Before that rule, people who were on their parents' plans lost their health insurance when they got too old to qualify as a dependent, or when they graduated from school or changed jobs.

Since the part of the law went into effect in September 2010, though, the proportion of adults ages 19 through 25 with insurance increased to 75%, or nearly 3.1 million, last December, up from 64%.

"This policy doesn't just give young adults and their families peace of mind, it also gives them freedom," HHS Secretary Kathleen Sebelius, said in a statement. "As they begin their careers, they will be free to make choices based on what they want to do, not on where they can get health insurance."

The health care reform law also requires all Americans to buy health insurance by 2014 or pay a fine. The intended goal is to force more uninsured Americans, including young adults who have opted out in the past, to buy insurance.

Adults 30 and younger are the ones least likely to have health insurance. Before the Affordable Care Act, many in this age group couldn't afford coverage. And many who could, and who were healthy, chose not to in order to save money. They became known as "young invincibles."

People who make about $29,000 and qualify for Medicaid health insurance might have to wait to see if the state they live in joins the program's expansion.

But the recent Supreme Court ruling wasn't a total victory for the Obama administration, though. Roberts said the law's required expansion of Medicaid violates states' rights. He said the federal government cannot require the states to follow that part of the law. States that want to take extra federal money can do that, he said, but they cannot be threatened with losing all federal funds if they refuse to expand the program.

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