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Supreme Court Rules on Affordable Health Care Act, Affecting Thousands of Iowans

The Supreme Court made a landmark ruling on the Affordable Health Care Act this morning deciding on the legislation that has become known as ObamaCare.

In a landmark ruling, the Supreme Court has upheld the Affordable Health Care Act -- ObamaCare -- giving the president a major political victory and maintaining health care coverage for thousands of Iowans.

Chief Justice John G. Roberts Jr., writing for a 5-4 majority, said that the U.S. Constitution gives Congress the right to impose individual mandates, the center-piece of the legislation, according to The New York Times.

"Holy crap," said Isa O'Hara, owner of the in Historic Valley Junction, in the minutes following the ruling. "There goes the country. I guess it was already sliding downhill."

The decision did significantly restrict one major portion of the law: the expansion of Medicaid, the government health-insurance program for low-income and sick people, The New York Times reported. The ruling gives states some flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for.

The Affordable Care Act, which was signed by President Obama in 2010, puts in place consumer protections and provides additional coverage options.

The reforms were intended to gradually roll out starting in 2014 and through later years.

The Supreme Court was tasked with determining the constitutionality of the law, focusing mostly on the requirement that Americans purchase insurance or face a fine.

O'Hara had multiple questions after the news broke.

"How on earth are we going to pay for it?" She said. "How many trillions is this going to cost us? What's happened to accountability? Is Congress going to be forced to take this on as their own healthcare?"

Affect on Iowans

Since being signed into law, Iowa families have received the following benefits from the Affordable Care Act, according to the U.S. Department of Health and Human Services:

  • 42,015 Iowans on Medicare saved an average of $616 on prescription drugs, for a total savings of $25,876,475.
  • 18,012 Iowans under the age of 26 gained coverage under the health care law.
  • 388,676 people with Medicare in Iowa received free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor.
  • 1,187,000 Iowans, including 433,000 women and 311,000 children, are free from worrying about lifetime limits on coverage.
  • Insurance companies are required to spend 80% of premium dollars on health care instead of overhead.

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Jeff Klinzman July 5, 2012 at 02:12 am
Jack, it is ridiculous and indefensible to play victim as you have here. You're acting like you've been subjected to oppression because you call yourself a white christian. Just admit that some of your compadres were over the top in how they portrayed Nancy Pelosi. And how the heck can you claim that you have any idea who my "ancestors" were!?
Bottom line is you guys have overplayed your hand in opposing the Affordable Care Act: polling data shows that most Americans want you to shut up so we can move on. More to the point is that healthcare organizations and insurors are now working to meet the mandates of the new law. The only folks who haven't moved on are those elements of the GOP who have lapsed on their rabies vaccinations. Shall I just call you "Ol' Yeller?"
Jack F July 5, 2012 at 02:28 am
Jeff... You are correct that most Americans want more free handouts. What you refuse to share is that the majority of Americans don't pay the majority of the taxes that hand them what they want. They are cattle at the public trough wanting others to pay "their fair share" as definined by government to keep votes and promote class warfare. If we follow your tard logic of a majority of the mindless masses want it, we would still have "separate but equal.". A majority of the country agreed with it and continue to segregate themselves through multiculturalism and by creating their own segregation by living choices.
Troy Murphy July 5, 2012 at 02:32 am
Sorry Jeff there is no way in ... that we could be over the top in how we portray Nancy Pelosi. She has to be the craziest most delusional person on the whole planet. You have to pass it to see what's in it. Really? Let alone the claim that Holder is being held in contempt because we want to suppress the vote. Here are a couple more gems from her. 1. Bipartisanship is nice, but it cannot be a substitute for action, not having it cannot prevent us from going forward. 2. In our recovery package we put new standards of accountability and transparency, which we hope will now apply.
Jack F July 5, 2012 at 02:42 am
World according to Jeffrey- their ancestors did bad things so now it is ok to do bad things to them. All spawn of the Nazis should be rounded up and placed in concentration camps. All white Christian males who Ancestors created this great country should forfeit all of their wealth to be redistributed to less fortunate because they didn't come by it honestly. The sons and daughters should "pay" for the sins of their forefathers. Fact Jeff- a black male became president before a female... White or black. Racism against minorities is dead... The war is over and good won... Now there is just piling on. My kids went to college with better grades and didn't receive half the hand outs as others because they did not have the correct genetic background. They owe more than some of their good friends because their parents immigrated to America. My kids are starting out with a chain heavier than minority kids because I am the wrong color. If my one sone would have claimed he was gay his financial aid would have been greater. They did nothing to anyone and have many ethnic friends that come over. However, the Dems and Pelosi have targeted them to carry a greater burden than their peers.
Billy Zelsnack July 5, 2012 at 04:00 am
Mental retardation is no longer the proper term. The proper term as of 2010 is intellectual disability. It's understandable that most people would not know of the change. The only reason I know about the change is because I have a friend with a Down's child.
Troy Murphy July 5, 2012 at 05:36 am
Thank you Billy, Is the old term considered offensive? Do they mean the same thing? Sorry I really am curious, did the term change in a professional way ie psychology, medical terminology or is this just the new accepted term to be politically correct? Thanks in advance
Kurt B. July 5, 2012 at 10:41 am
@ Jeff Klinzman - your comment posted at 7:34 on the 4th...... this is pretty far-fetched . I don't quite see what you are trying to do. Blaming a confederate prison in Georgia on current people ? Or a Civil War battle in Tennessee - the outcome is our fault ?
How about if we stick to the conversation of the Health Care act and what it means to everyone ( if anyone has any idea , which I think the whole thing is full of surprises for all Americans, Dems Reps and Independents ). 2700 pages - that is a pretty huge document to expect anyone to comprehend.
Jeff Klinzman July 5, 2012 at 11:35 am
Troy, "idiot," "moron," and "cretin" used to be clinical terms denoting varying levels of intellectual disability. The medical profession abandoned their use once they made it into the popular lexicon as insults. Why do you have to blame "the left" for a simple fact: language changes? And look at your buddy Jack: he used "tard" as an insult, much like many adolescents do, which is why professionals in mental health and social work are abandoning the term "retarded." Is it really asking that much for people to be aware of how they use language and to, well, THINK!?
Jack, your rants remind me of what conservatives were saying about multiculturalism in the 1990s, that we were encouraging people to identify themselves as victims. Think about that: you come off like a person who feels he's been victimized, and who seems to have a Jupiter-sized sense of entitlement. We used to call that "white skin privilege!"
Jeff Klinzman July 5, 2012 at 11:47 am
It's pretty simple, Kurt. Jack above is claiming he is a victim of racial discrimination because he considers himself a "white upper middle class christian" (his words). I was just indicating some of the ugly history produced by men who, like Jack, identiifed themselves that way. For what it's worth, there is no such thing as a "white" person. I'm of German-Irish stock, both immigrant groups who were disliked when they first arrived in this country. If you don't like my reminder that history didn't start yesterday, then you needn't read my posts.
Jack's means of identifying himself have been used to divide and oppress people in the past, and they continue to do so today. Jack could have easily identified himself by his profession, as a father, and yes, as a christian. Jack's posts are very relevant here: the GOP has been playing a divide-and-rule game with the American people, stoking fear and resentment, and the ACA has been a particular target. I do contend that many critics of Obama are motivated by resentment which is based on latent racism. You don't have to be obvious, overt, or even conscious of racist motives. That's why this part of the discussion is germane. Review this thread and tell me how many of the criticisms of the ACA are based on reason and evidence, and how many come from fear? And, why are the criticisms all negative, with no alternative offered to reform American healthcare?
Kurt B. July 5, 2012 at 08:19 pm
I understand a little better now. And, I think everyone here realizes history did not start yesterday. I just didn't see any connection between the Confederate prison ( spelled Andersonville, b.t.w. ) , or an 1864 battle in Tennessee with a real bad turnout ( not uncommon in war ). Shermans March to the Sea wasn't so glorious either, but it is sure touted as a huge victory for the north in the history lessons.
Back to the subject - this act will be a real burden on an awful lot of people. Call it a tax, a penalty, or whatever. It is going to be a burden.
Maria Houser Conzemius July 5, 2012 at 08:40 pm
Kurt B., for those of us who pay for the emergency room visits of uninsured patients who don't or can't pay their medical bills, the Affordable Care Act will be less of a burden. For the uninsured with preexisting health conditions, it will be a way to get the health insurance they desperately need and are willing to pay for. In the past, health insurance companies wouldn't take customers with preexisting conditions (effective 2014 they'll have to; children with preexisting conditions are already covered) and also dumped the insured once they got sick.
Troy Murphy July 5, 2012 at 09:48 pm
Jeff, What would you call our current welfare system except a divide and conquer game started by the Democrats and continued today. Do you realize since the advent of modern welfare the African - American community has a 73% single parent rate compared to 25% nationally. The welfare system has created a permanent underclass in the US, with Barack being elected President you can't even blame the problem on racism. The problem can be traced directly back to the current social welfare state. We pay people to have children and encourage the fathers to leave and be irresponsible because the mothers get more aid when that happens. The social welfare system destroyed the family structure because it is no longer beneficial to get married or to stay married. So tell me who's best interest it is to keep people dependent on government, it sure isn't the GOP's. The Holier than thou attitude expressed by the Democrats while they play the divide and conquer race card, stoking fear and resentment of Republicans by accusing us of wanting to starve the poor and elderly. Such hypocrisy.
Kurt B. July 5, 2012 at 10:04 pm
+1 for Maria. Yes, I agree ..... there are some parts of this act that we already know about, and are good - such as the ones you have mentioned. The "bad" of this act is probably 99% unknown ( cost ???? ). And, I don't know if anyone knows the answer to this one or not : Is there a "bid" system involved in this "affordable" act ? What this means is ..... let's say you. Maria, need a knee replacement. The operation is put up for bid and let's say the winning bid is $10,000. Not bad you say, but the catch is .... you have to go to Seattle to take advantage of this. Or, overseas perhaps. Then, you start asking , what if I get the operation done locally ( Iowa City, Waterloo, etc. ) but their "bid" is $20,000. Now what ? Who pays the excess over the low bid ? - my guess is the customer pays the difference.
All I am saying is ..... with a 2700 page act, there is alot of wording going on there and I don't think there is anyone alive that understands the thing - tho Pelosi might claim she does. The last thing for all of us to ask is : why aren't the elected officials on this wonderful plan ? Maybe Grassley or Harkin can enlighten us.
Troy Murphy July 6, 2012 at 01:19 am
" Review this thread and tell me how many of the criticisms of the ACA are based on reason and evidence, and how many come from fear? And, why are the criticisms all negative, with no alternative offered to reform American healthcare?" the above is just disingenuous, if this was an article titled how do we improve Obamacare I am sure you would get the posts you were looking for, they are negative because they are criticisms, Duh. If you would like to ask the question what things do you like about Obamacare I am sure this evil, bigoted, racist, sexist and homophobic white upper middle class male Christian Republican would be more than happy to answer ;). Just in case anyone doesn't get the above line it was sarcasm. Yes, they are based on fear, fear that you are going to reach into my pocket and everyone else's. Fear of what this will do to the American economy, fear of the price increases to my and my employees healthcare and fear of how the bureaucrats will interpret 2700 pages that no one has read or understands
Troy Murphy July 6, 2012 at 01:33 am
Sorry Jeff you should read who posted before making a comment. No, twist it how you like but I said nothing about being promiscuous, yes irresponsible because of the welfare state because it pays to be irresponsible. You called welfare recipients lazy not me, I said it was easier it does not necessarily follow that they are lazy just smart and yes Democrats keep them dependent it was you who said they were stupid I believe your interpretation of my comment shows the racist and class warfare tendencies of the liberal left. My was just an observation that since the arrival of the modern welfare state it has been black families that have suffered.
Jack F July 6, 2012 at 01:35 am
Jeff- remember Hotel Rowanda???
Troy Murphy July 6, 2012 at 01:39 am
It sure isn't us Rich white Republicans who benefit by keeping people dependent, since most welfare recipients vote Democrat it is in the Democrats best interest to have more dependent people who will vote for them. Us rich Republicans would like to see more people working so we can lower our tax burden.
Jack F July 6, 2012 at 01:45 am
Your like all liberals.... If they don't agree then obviously they have latent racist motivations that are so deeply embedded in their white genetic code that there is no way they can be trusted. Fact is that minorities are just as racist and motivated by cultural influences. However, our current society accepts their racism because they are the oppressed. Bunch of Blarney Jeffery.
Todd Richissin July 6, 2012 at 01:56 am
Jack, I've deleted another of your posts. Debate the issues, if you'd like, but please refrain from personal attacks, including name calling. We want a site where all people feel free to express themselves without the personal remarks.
Jack F July 6, 2012 at 02:55 am
Todd- I expect that you will delete the posts where Jeff starts calling me a racists????
Kurt B. July 6, 2012 at 09:41 am
@ Jeff Klinzman - please be very careful about your posts. Your 9:09 p.m. post ( Jul 5th ) says that I said something which I didn't even come close to saying. I was questioning your reference to a Civil War battle in TN and prison in GA and this was in no way even close to what you are saying I said. 100% totally inappropriate and I hope Ashlee Kieler is monitoring this string and cleaning things up. Maybe also reminding those like you of such improper comments. Please remove your comment from the string.
Maria Houser Conzemius July 6, 2012 at 01:07 pm
Kurt B., I don't believe that Americans would tolerate having to go out of state or out of country for their knee replacement surgery. Remember when insurance companies tried to enforce "drive-by deliveries," that is, in-and-out deliveries and hospital care for 24 hours max except for complications, for pregnant mothers and newborns? It didn't fly. Sometimes Americans actually stop acting like sheep and rear back on their hind legs and fight back. Those in power call fighting back "class warfare."
BTW, I've already had one hip replacement surgery at University of Iowa Hospitals and Clinics. The cost was $33,000; Wellmark Blue Cross/Blue Shield negotiated down the price to $19,000. If I were uninsured and had to pay out of pocket, I would have paid $33,000. In India I could have had the same surgery for pennies on the dollar with deluxe, resort-style care afterwards for six weeks. I actually thought about going out of country to have my surgery, but I wasn't sure my insurance would pay for it. Americans pay twice as much as any other country for health care, yet our outcomes are not as good as those in France. France is rated #1 in health care, not the United States, and care is cheaper there.
Troy Murphy July 6, 2012 at 01:21 pm
Jeff, Yeah, like your views aren't prejudiced. BTW Kurt never said anything about black welfare recipients I did. I am sure your view is so unbiased, what doesn't bode well for the country is government debt greater than the US GDP. This monstrosity the (un)Affordable Care Act will do nothing to help decrease this number. We don't have a taxing problem in the US we have a spending problem. You could confiscate all the money and wealth from the top 50% of Americans and still not pay off our debt. That is what doesn't bode well for our country
Maria Houser Conzemius July 6, 2012 at 01:26 pm
Jeff, I do think the left needs to read the Moynihan Report of 1965 and "American Murder Mystery" by Hanna Rosin in the July/August 2008 Atlantic magazine to understand the many unintended and negative effects of the War on Poverty. Sen. Daniel Patrick Moynihan (Democrat) predicted the deterioration of the African-American family as a result and he was right. Hanna Rosin's findings were equally startling.
As a former social worker, I do believe that the War on Poverty has had some unintended effects on all races and they are alarming. Having said that, I think that with this economy, it's a hell of a time to cut back on food stamps, which is what the U.S. House just voted to do.
Jeff Klinzman July 6, 2012 at 01:36 pm
Thanks, Maria! Let me add the following: we DO have healthcare rationing in this country, performed by unaccountable private insurors who, among other tactics, employ doctors who are rewarded financially for finding grounds to reject claims. This country spends twice as much, as a total percentage of care, to administer claims: that is waste, pure and simple, since processing claims paperwork does nothing to provide care to patients.
You won't be able to nationalize GSK, since that company is based in the UK, but the pharmaceutical industry is also wasteful: look at the money spent marketing name-brand drugs to patients. Another example where every dollar spent on advertising contributes nothing to patient care. Let's not forget the GW Bush Medicare prescription fiasco, with its "donut hole" of coverage and prohibition against the federal government negotiating with Big Pharma for reduced prices. Talk about interfering with the function of the "free market!" These guys will stoke resentment of us, since we have Wellmark insurance. Funny how they'll gripe about how "the gubmint" will prevent us from choosing our care providers: as you know, Wellmark has its network of "preferred providers," and my wife had to go to a different optometrist for her new glasses: our old provider wasn't part of Wellmark's network. But like rationing, that kind of behavior is okay, since its done by a for-profit corporation!
Todd Richissin July 6, 2012 at 01:45 pm
It's good to discuss important issues of the day. It's also important to have some good fun. For you energetic commenters out there -- who we love -- check this out, and have some fun. http://patch.com/A-vNZ4
Kurt B. July 7, 2012 at 10:11 am
Another +1 for Maria.
But, if going somewhere far away were part of the law ( the health care act ), could Americans actually do anything about it? I see this very similar to putting out bids on a new building , a new parking lot, etc. The low bidder usually gets the business ( if he/she is qualified, of course ). The difference is ...... the bidder ( in the case of a structure ) must go to the site. For health care, the patient would have to go to where the service will be provided. And..... in the case of negotiating a lower price, in your case you were successful. If the whole situation becomes a matter of dollars and cents , and there is little room for negotiating, then what ? ( i.e. what would have happened if Wellmark had negotiated a cost for you of $32,995 ? - take it or leave it . Would you have gone to India ? ) Like I said earlier, the whole act is not very clear yet. Especially in the area of costs. Does anyone reading these posts know if there is a bidding process as part of the services provided by the Act ?
Maria Houser Conzemius July 8, 2012 at 02:32 pm
Kurt B., thank you. I'm unaware of a bidding process. There's a lot we don't know yet, but what I do know, I like. My daughter is covered till she's 26. By that time, I'm fairly sure she will have a job with good health insurance of her own.
The costs you are worried about are already astronomical. Americans pay twice as much as other countries for health care and quality of health care varies widely. A young friend of my daughter's went to Mercy Hospital in Iowa City and was not treated appropriately for an infection, probably because he had no health insurance. He didn't get antibiotics for a serious foot infection until his father took him to a doctor and paid out of pocket for the appointment and the medication. I was shocked. When I was a social worker, I took a client who had had an untreated ear infection since she was a child. She was in her fifties and she desperately needed serious intervention. But she lacked health insurance, so her Mercy-affiliated ear doctor refused to treat her. I was shocked, but I was there, so I know it happened.
Kurt B. July 8, 2012 at 04:15 pm
I don't know for sure, but I think this act will help with some of the things you mentioned ( one of the summaries I have heard said that fraud is one issue the act would deal with ). However, cost is still a huge question and I cannot help but think that our gov't will institute a bidding process as a way of controlling costs. The other thing that seems to be a hidden issue is : what will companies do to deal with this monster ? I can't imagine every company with more than 50 employees having an A.C.A. ( affordable care act ) expert..... it would take years to learn the ins and outs of this 2700 page thing. Companies with less than 50 employees will really have a problem. ( can't justify one person to do nothing but be an A.C.A. expert )
Maria Houser Conzemius July 8, 2012 at 05:25 pm
Kurt B., some say that private health insurance may be so costly that the Affordable Care Act will go to a single-payer model like Medicare and Medicaid. Many Democrats wanted a single-payer health insurance system all along. And lest people think that's a bad thing, remember the old woman who cried, "Keep the government out of my Medicare!" She likes her health insurance but didn't know who provides it!
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RB March 28, 2013 at 01:28 pm
Ashlee .... I just came to visit as you are leaving ..... Would YOU consider a NATIONAL or AMERICA'sRead More PATCH.
B.A. Morelli (Editor) March 28, 2013 at 04:11 pm
So, sad to see you leave, but it sounds like a great opportunity ahead, Ashlee. You've been a greatRead More part of Patch. Thank you!
Beth Dalbey (Editor) March 28, 2013 at 06:29 pm
Very nice farewell, Ashlee. Have so much fun in Washington, DC that you can't stand it.