Issues

On health care

The 2010 overhaul of the nation’s health care system championed by President Obama, which passed without any Republican votes, continues to be debated in the courts and in Congress as its provisions take effect. The law is projected to reduce the number of uninsured by 32 million in 2019 and gives new protections to the insured.

Parts of the bill have already kicked in. Among those are: a provision that allows young adults to stay on their parents’ insurance plans until age 26; prohibiting insurers from denying coverage to children with a pre-existing condition; and phasing out the gap in Medicare prescription drug coverage;

Among the major provisions that don’t begin until 2014 are: requiring most people and businesses with more than 50 employees to buy insurance or pay a penalty; expanding Medicaid eligibility; and setting up state-based exchanges to help small businesses and individuals purchase insurance with subsidies for some.

The Supreme Court will hear arguments next year over challenges to the law’s constitutionality, which focus largely on the requirement that all people have insurance. States, which have a major role in implementation, are deciding whether to run the state-based exchanges that begin in 2014 or to let the federal government handle that.

The GOP candidates say repealing the health care law is a top priority. Their alternatives include long-standing Republican initiatives such as expanding health savings accounts, limiting medical malpractice awards, giving tax credits to the self-insured and allowing people to buy insurance across state lines.

-Maureen Groppe, Gannett Washington Bureau