By Quentin Fottrell
The Supreme Court’s decision to uphold the key provisions of President Obama’s Affordable Care Act will benefit two groups the most, experts say: older Americans and the self-employed.
The court found the individual mandate, the requirement that all Americans purchase health insurance, is constitutional. Signed into law two years ago, the sweeping reform is expected to give 30 million more Americans access to health insurance by 2014, making preventative care available to many who in the past avoided seeking treatment until absolutely necessary. It also requires insurers to give people free access to blood pressure, cancer, diabetes and cholesterol tests. “This is the biggest change in health care in this country in a generation,” says Susan Nash, a partner in the law firm McDermott, Will & Emery.
That said, the law will impact certain groups more than others. Younger and healthier Americans who have had cheaper premiums and higher deductibles will be forced to pay more, while the expansion of Medicaid will benefit poorer and sicker Americans who couldn’t afford health care until now, says Wendell Potter, former vice-president of corporate communications at Cigna. Of course, even experts say it’s unclear how quickly some of these changes will take hold; for example, some question whether all states will be able to roll out online “exchanges” designed to allow people to shop for individual insurance plan by 2014.
Some things may not change much at all. With or without Obamacare, most analysts say that health insurance premiums will continue to rise. “Consolidation within the industry means that people will have less choice,” says Alex Morozov, a senior health care analyst at Morningstar. In fact, the two largest insurance companies have a 70% market share in nearly half the 50 states, according to the American Medical Association. In 54% of metropolitan markets, at least one insurer had a market share of 50% or more, the report found.
Here are some of the likely consequences of the court’s decision for five key groups – and what might have happened had the decision gone the other way: