|By Alex Nixon, The Pittsburgh Tribune-Review|
|McClatchy-Tribune Information Services|
The court's ruling could profoundly affect the Joyce family and millions of others across the nation. Among questions the justices are expected to address are two that attracted the most attention for consumer impact: Can the government force people to buy health insurance? If not, should the entire law be nullified?
"In the center ring is definitely the question about the individual mandate," said
Joyce, 55, a part-time farm worker from Cecil, and her 21-year-old daughter, a hair stylist, have chronic medical conditions. That makes it difficult and costly to obtain insurance without coverage from an employer's group plan. Joyce's husband, a truck driver, provided insurance for the family until last year when his company reclassified his job and cut the benefit.
They pay nearly
If the court upholds the law, in 2014 it would bar insurers from excluding people because of chronic conditions. By that year, states must have established health insurance exchanges for people to buy insurance at competitive rates. Both aspects could help the Joyces.
But if the court strikes down the law, Joyce worries that a serious illness or accident could drain the family's savings.
"We were always the ones that thought, if something happens, that our children could come to us and we could help them. Now I'm afraid that we couldn't do that. We'd be the ones in their basement," she said. "I feel vulnerable, I guess."
Supporters say millions of Americans are benefiting from portions of the law, including:
--More than 5.1 million people with
--About 100,000 Pennsylvanians who purchased individual health insurance and will receive rebates from insurers;
--About 50,000 adults with pre-existing conditions, including nearly 5,000 in this state, covered through a government-subsidized program;
--An estimated 3.4 million young adults receiving coverage on their parents' plans until age 26.
Critics are skeptical of those numbers and say negative consequences outweigh the positive ones.
"This was not a well-thought-out piece of legislation to start with," said
The law forces new costs onto employers, said Haislmaier, who predicted many employers may stop providing insurance to workers. The
Many businesses "don't know a lot about the law" or how it will affect them, said
The law makes available tax credits to help small businesses pay for health insurance for employees and an estimated 160,700 companies in the state qualify. Yet it's unknown how many take advantage of the incentives.