One year ago today President Barack Obama signed into law the Affordable Care Act, a historic accomplishment now under a partisan, legal assault that needs to be resolved by the U. S. Supreme Court. For decades, presidents have tried to address the health insurance crisis that afflicts millions of uninsured Americans, only to be defeated by organized special interests. While the law and the health insurance safety net it establishes won't be fully implemented until 2014, the reforms already are paying health care dividends to a wide swath of Americans.
Parents now have the right to demand that health insurers extend coverage to their adult children up to age 26, and insurers are barred from denying health insurance to children with pre-existing conditions. Health insurers can no longer impose lifetime limits on benefits or drop people due to mistakes in the their health insurance applications. And about 256,000 Florida residents on Medicare who hit the "doughnut hole" under their prescription drug benefit last year received $250 in rebates. The law eliminates the doughnut hole by 2020.
But the biggest benefits start in 2014, when health insurers will be barred from denying coverage based on a pre-existing conditions, everyone will be expected to have insurance, which will bring down costs, and it will be made affordable through federal subsidies.
Despite this demonstrable good, Republican politicians at the federal and state level have led a determined campaign to turn Americans against what they derisively call "Obamacare." The law's most controversial element, the individual mandate that requires everyone to have health care coverage or pay a penalty, is similar to the state health insurance program championed in Massachusetts by former Gov. Mitt Romney. Yet as a potential Republican presidential candidate, Romney denounces the federal version of his own program. The reforms have met a solid wall of opposition from Republicans who would rather let America's 50 million uninsured fend for themselves or use hospital emergency rooms for primary care.
In Florida, with 4 million uninsured residents, Republican Gov. Rick Scott has used the ruling by Pensacola-based U.S. District Judge Roger Vinson striking down the law as an excuse to ignore parts of it and reject $2 million in federal grants for its implementation. Vinson's ruling contrasts with three other federal judges who have upheld the law's constitutionality — a position better grounded in legal precedent. But the sooner this is resolved the better. It is helpful that the 11th U.S. Circuit Court of Appeals agreed to expedite an appeal of Vinson's ruling, greasing the case's path to the U.S. Supreme Court.
In the meantime the Affordable Care Act is valid and operational, working to provide a host of protections for health insurance consumers. It is a great step forward in providing a much-needed social safety net for all, and the sooner the courts provide clarity, the better.