There was an op-ed in the LA Times written by one Ms Ward, a woman with breast cancer. It's well worth reading, and I'll quote some of it here, but the whole thing is worth the read:
I want to apologize to President Obama. But first, some background.
I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. ... With the recession, both of our businesses took a huge hit — my husband's income was cut in half, and the foundations that had supported my small nonprofit were going through their own tough times. We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost.
... If you are fortunate enough to still be employed and have insurance through your employers, you may feel insulated from the sufferings of people like me right now. But things can change abruptly. If you still have a good job with insurance, that doesn't mean that you're better than me, more deserving than me or smarter than me. It just means that you are luckier. And access to healthcare shouldn't depend on luck.
Fortunately for me, I've been saved by the federal government's Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It's part of President Obama's healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It's not perfect, of course, and it still leaves many people in need out in the cold. But it's a start, and for me it's been a lifesaver — perhaps literally.
It hits home, for obvious reasons, but it's also important for another reason. So much of the battle over ObamaCare has focused on the Greatest Threat to Liberty Since Slavery, the individual mandate. It's utter, cynical, opportunistic bullshit, of course, since for years and years the mandate was the conservative counterproposal to further-reaching liberal plans. But after the PPACA passed, it was the only legal line of attack conservatives could find, and so here we sit, wondering what the most powerful man in America, Justice Anthony Kennedy, will do.
Will he strike down the entire law? Will he sever the mandate and leave the rest of the law? I have no clue. (I am assuming that the rest of the court will vote in their partisan blocs. Surprise me, guys!) But whenever this comes up in the media or in discussion, the flash point, the focus of the debate is the evil or awesome individual mandate.
What gets forgotten, though, is how much more is in the law than the mandate. While most of the attention during the drafting of the law rightly went to the plight of the uninsured and the near-universality of the coverage, much and more of the law was devoted to root-and-stem health insurance reform.
Reforms that help women like Ms Ward. Without the high-risk pool the PPACA established, she would be without any relief. State high-risk pools are unsubsidized and the premiums are unaffordable. The only reason this program is feasible is because it is temporary -- a bridge to 2014 when the insurance exchanges go into place, along with other critical insurance regulations.
Why does this matter? Because people like Ms Ward are in the individual market, and insurers individually underwrite each applicant -- and refuse those who are bad risks. Come 2014, every individual policy will have to go through each state's health insurance exchange, and they must conform to a number of new requirements. They cannot refuse any applicant. And they may no longer charge different premiums for patients with varying health histories, a feature called "Community Rating."
This is, it must be understood, how large insurers currently work. If you go work for Boeing, they don't ask you before you are hired whether your wife has breast cancer. All employees get charged the same, and the premiums for the entire pool adjust to cover the aggregate cost. All the PPACA does here is bring the same rules that the group market already works under to the individual market. And that's huge for so many people.
This is just one bit of the law that really matters to people, and that really will make the difference in the lives of so many Americans. And there is so much more. The requirement that insurers must spend 80% of premiums on actual healthcare. The prohibition on insurance "takebacks," or recissions. The expansion of coverage for kids. The requirement that premium increases must be reasonable and justified. Increased funding for primary care and community health clinics. And on and on.
So the next time you are inclined to go off on a spittle-flecked rant over the individual mandate (and I've emitted a few of my own), just pause and take a moment to remember that there is a lot more in this law than the mandate. I'm not going to persuade anybody who's already formed an opinion that the mandate really is good policy, but maybe I can remind them that a nuanced view of the law might be in order. It's not black and white. Regardless of the fate of the mandate, we should all be hoping that Justice Kennedy lets the rest of the law stand.