Now we're just trying to find out what's in the bill?
There are quite a few provisions in the ACA, some of which have already taken effect and others of which will be coming along soon. You can get a helpful timeline right here.
Provisions that have already taken effect include:
- * Prohibiting insurance companies from denying coverage of children based on pre-existing conditions
* Prohibiting insurance companies from unilaterally rescinding coverage
* Eliminating lifetime limits on insurance coverage
* Providing external review for appeals of insurance company decisions
* Providing health insurance tax credits for small businesses
* Fixing the Medicare Drug benefit by closing the prescription drug "donut hole"
* Cracking down on health-care fraud
* Allowing young adults to stay on their parents' insurance plans up to age 26
- * Reduction in paperwork and administrative costs (2012)
* Expanded preventive health coverage (2014)
* Tax credits for middle-income households purchasing insurance (2014)
* Establishing competitive health-insurance exchanges, open to the public (and required for all members of Congress) (2014)
* Mandate requiring individuals to either carry insurance or pay a fee to cover the costs of medical care for the uninsured (2014)
This is not the way I would have chosen to pursue health-care reform -- it's mostly a lot of band-aids to fix glaring problems with the current system, while not eliminating the fundamental reliance on private companies to provide health insurance. It may slow the growth of health care costs, but it will still leave America with the most expensive and inefficient health care delivery system in the OECD. However, it's certainly a vast improvement over doing nothing.
I don't expect the Supreme Court to toss the ACA out. If they did, it would negatively impact a large number of people.
It would also probably mean that no significant changes would be made to health care financing in this country for at least the next decade. During that time, costs would continue to rise, US companies would become progressively less competitive, and more and more households would suffer from the kinds of infuriating problems that are created by the pre-ACA system.
Eventually, the current system becomes unsustainable. The ACA was a basically conservative attempt to prevent that -- mitigating some of the worst problems, but leaving private health insurance basically intact. If that attempt were killed (either by the Court, or by the GOP) the next attempt would likely be far more radical, but many people would suffer greatly during the "lost decade" of delay.