Saturday, December 7, 2013
By CHRISTI PARSONS, LISA MASCARO and KATHLEEN HENNESSEY McClatchy News Services
WASHINGTON - As the nation's capital prepared Wednesday for the Supreme Court's long-awaited ruling on President Obama's health care law, the White House was unusually quiet.
Q & A ON THE IMPLICATIONS OF THE SUPREME COURT RULING
Q: What's happening with the national health reform law today?
A: The U.S. Supreme Court is expected to issue its long-awaited decision about the constitutionality of President Obama's landmark legislation around 10:15 a.m.
Q: What might the court do?
A: It could throw out the law entirely, declare it all constitutional, or reject one portion, such as the mandate that most Americans obtain health insurance, or the planned expansion of the federal Medicaid program for low-income people.
Q: Will the court definitely issue a decision today?
A: No. It could decide to postpone a ruling and either hear more arguments next term or conclude that it doesn't have the authority to rule until 2014, when the mandate to obtain health insurance goes into effect. However, many experts consider a delay a long shot and believe the court will issue an opinion today.
Q: If the entire law is overturned, how will it affect me?
A: The law contains consumer protections already affecting millions of people that may be eliminated if it is ruled invalid, including:
n Help for seniors who hit a Medicare prescription drug coverage gap known as "the doughnut hole."
n The elimination of lifetime caps on health insurance benefits.
n Free annual wellness visits for Medicare recipients and free preventive services such as mammograms and colonoscopies.
n Insurance company rebates. These are required when insurers fail to spend at least 80 percent of premiums on medical care and quality improvement, rather than salaries and other administrative costs.
n A requirement that beginning in 2014, insurers accept all people, regardless of pre-existing health problems.
Q: Would all of the law's major provisions disappear if it is ruled unconstitutional?
A: No. California, for instance, has passed laws implementing some changes, so they will remain in effect no matter what the Supreme Court decides. These include:
n Young adults will be able to remain on their parents' health insurance policies up to age 26.
n Insurers can no longer reject children under 18 because of their health problems.
n New health insurance policies must cover maternity services.
n Insurers can no longer cancel people's coverage when they become ill because of unintentional misrepresentations on their applications.
Q: What happens if the court leaves much of the law intact, but throws out the mandate to have insurance?
A: The Obama administration argued that if this key provision is overturned, the court should also remove the requirement that insurers accept people with pre-existing medical conditions and refrain from charging them higher premiums. Without an influx of healthy people into insurance pools, the administration said, it would be too costly to force insurers to accept all of the sickest people. That could cause premiums to skyrocket.
-- By McClatchy News Service
The ruling on Obama's biggest domestic accomplishment could be among the most consequential events in his presidency, but he will learn about it at the same time as the rest of the nation, receiving no advance warning as he does for such government actions as the release of unemployment statistics.
So, a White House that so often pre-spins the news has maintained a studied silence about Obama's plans. His staff won't even say whether he will make a public appearance or statement today, a day he is scheduled to spend in meetings at the White House. "I cannot speculate on all the various permutations," said White House press secretary Jay Carney.
The administration, like the rest of Washington on Wednesday, was running high on adrenaline with no real reason to sprint. "We're all hurry-up-and-waiting," said Rep. Peter Welch, D-Vt.
Outside the Supreme Court, its stately neo-classical facade covered in scaffolding for an inconveniently timed improvement project, the scene was eerily serene. A few camera crews staked out spots on the front steps, tourists strolled about and there was no sign of the frenzy to come.
But inside the Capitol, lawmakers and their aides were frenetically drawing up plans to respond to the court's decision. Welch, after a morning jog on an unusually cool day, headed to his office to work the phones for his Plan B: legislation that would provide Medicare for all.
Throughout Washington, advocacy groups were also running through scenarios. Health policy experts traded predictions on Twitter. A tea party group prepared to livestream its views from the court steps.
What the nine justices decide could change the course of the nation's health care system and the fall election campaigns. The Affordable Care Act, designed to increase the number of Americans who have access to health care, has become one of the most potent examples of how far apart the two political parties are on the role the federal government should play in the lives of Americans.
Democrats and Republicans alike hope to turn the decision to their advantage on the campaign trail.
Thus has Washington been turning longingly to the court for the past two Mondays and Thursdays, days the court could have handed down decisions. CSPAN -- the wonk's ESPN -- has broadcast live outside of the court, showing images of protesters, passersby and journalists milling around.
Today is the final day the court could issue the opinion this term.
House Speaker John A. Boehner, R-Ohio, met behind closed doors in the Capitol basement on Wednesday, plotting another attempt to repeal the law, or whatever's left of it after today's decision.
"Regardless of how the court rules," Boehner told his troops, according to a source who was in the room, "the law is a huge issue for the American people, and it has to be repealed, completely."
Democrats have been more muted, perhaps reflecting an unwillingness to acknowledge what may come.
Most Democrats in Congress don't want to revisit their controversial health care votes right before their re-election battles. Liberal Democrats are the exception; the Congressional Progressive Caucus has already booked a news conference outside the court immediately after the ruling.
Democratic Party officials said they were waiting for the White House's lead. The West Wing and the Obama campaign have already gamed out the options in broad strokes, officials say.
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