Since last Thursday, people all over campus have been climbing atop imaginary podiums and… Since last Thursday, people all over campus have been climbing atop imaginary podiums and spewing fancy words at each other. They’re arguing (intensely) over the difference between “experience-” and “community-rating,” about the specifics of the “Medicare Part D coverage gap” and whether the government has the right to require its citizens to purchase “minimum essential coverage.” The sudden commotion isn’t due to the wand-waving of a fairy partial to our verbosity and pomposity (as far as the Pitt News editorial staff can observe). Instead, the likely explanation is that on June 28, we witnessed one of the most important judicial decisions of modern times: President Barack Obama’s contentious health care law, commonly known as “Obamacare,” was upheld by the Supreme Court.
The resurgence of vigorous debate over the law’s merits is a healthy phenomenon for Pitt, but whatever conclusions individual students come to, we should not ignore the huge boon to young people this ruling represents. The law has its flaws, but it’s unqualifiedly good for Pitt students.
After years of legal wrangling over the constitutionality of the 2010 Patient Protection and Affordable Care Act, the Supreme Court delivered a clearer picture of the law’s long-term prospects: Barring state waivers from a future Republican president or an unlikely repeal by a future Republican Congress (the GOP would have to amass 60 votes in the Senate to beat filibuster), Obama’s health care reform is here to stay. Though it struck down the section of the Affordable Care Act that punishes states that don’t cooperate in Medicaid expansion, the Court voted 5-4 to uphold the main tenets of the law, including, most notably, the individual mandate.
You’ll find many people on the streets of Oakland who’ll tell you that the upheld law won’t be the end-all solution to our health care cost woes. They’re probably right. You’ll find other people who’ll tell you that the law forces you into the jaws of profit-hungry insurance companies. To some degree, these people are also right. What distinguishes the American health insurance system — the fundamentals of which the Affordable Care Act doesn’t change — from virtually every other industrialized country’s system is one sad fact: It’s based on structurally flawed, employer-provided private insurance.
The underlying problem is that due to the way the system is built, the current free-market insurance model will inevitably fail in one of two ways. Either the profit-maximizing companies fill their rolls with solely healthy people (this population rarely makes insurance claims), or — if they can’t exclude based on pre-existing conditions — the companies indirectly force healthy people out of insurance pools when health care costs start rising, causing premiums to price spiral and eventually making insurance unaffordable for those who actually need it. Both of these stories end with market failure: The sick (and the potentially sick) don’t get proper care, and any care they get comes at greater costs to society.
A similar frailty exists under the Affordable Care Act, which primarily seeks to universalize the private sector system instead of replacing it with something more robust (see Canada). By forcing individuals to either pay insurance companies or be fined, the new law exposes everyone to the problems of private insurance (these problems are mitigated, surely, with to-be-established “experience-blind” health care exchanges). And since the law prioritizes extending coverage over reducing costs, there’s also little reason to believe the law will miraculously reverse the ongoing ascent of health care costs. Sure, the new money for best-practices research might yield fruit, but even countries used to universal coverage are grappling with skyrocketing costs.
So by several measures, Obamacare falls far short of the ideal. But that doesn’t mean it doesn’t do something momentous. Not only does the Supreme Court ruling constitute a huge step toward a nicer society, it’s great for college students. Here’s how the Affordable Care Act will improve student lives:
Not having a job does not mean not having health care. Not only can you stay on your parents’ health insurance until your 27th birthday, but incoming insurance exchanges should make it easier and cheaper to purchase individual plans. In addition, you no longer will have to claim dependents or be disabled to qualify for Medicaid; you’ll just have to make below 133 percent of the federal poverty level, which applies to many college students who are neither dependents of their parents nor on their insurance.
You can get help to purchase health insurance. If you make between 133 and 400 percent of the poverty level, you are likely eligible for insurance subsidies from the government.
Your first employers will be more likely to provide health care options. Incentives are in place to encourage small and large companies to purchase efficient insurance plans.
Most of us won’t be forced into huge policies, contrary to popular belief. On the one hand, those without incomes big enough to pay federal income tax will be exempt from the individual mandate fine. On the other, people younger than 30 will be able to express their daring by choosing cheap, low-benefit “catastrophic” plans in insurance exchanges.
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