Health care overhaul takes root in divided U.S.

Mary and Joe Thompson stand with their children Sarah, center, Andrew, right, and Emily, front, at their home in Overland Park, Kansas. / AP

WASHINGTON - A year after President Obama signed his health care overhaul, the law remains so divisive that Americans can't even agree on what to call it. Even so, it is taking root in the land.

Whether it grows is another matter.

Polls show that about 1 in 8 Americans believe they have been personally helped already, well before the main push to cover the uninsured scheduled for 2014.

CBSNews.com Special report: Health Care

Still, issues of affordability and complexity guarantee ongoing problems, even if the Supreme Court upholds the landmark legislation that made health insurance both a right and a responsibility.

Supporters call it the Affordable Care Act, a shortened version of the official title Democrats gave their massive bill. It may be better known as "Obamacare," the epithet used by Republicans seeking its demise.

While Obama returns from Latin America on the signing anniversary Wednesday, administration officials will fan out across the country. Community commemorations that start Monday come as the health care battle moves to the states. Even states suing to nullify the law's requirement that most Americans carry health insurance are proceeding with building blocks of the new system.

Families, small businesses and seniors are starting to feel the impact of dozens of already in place. Interviews with people affected reveal it's not always clear-cut.

insurance changes

In small-town Circleville, N.Y., Patti Schley says the law has made a dramatic difference.

Her daughter Megan, 23, was out of college, going without insurance as she tried to launch a wedding photography business. Last summer Megan started getting sick and rapidly lost weight. Doctors diagnosed a serious digestive system disorder that would make her uninsurable.

But her parents were able to get her into a high-risk insurance pool created under the law, and this year Megan signed up for her father's workplace plan, under a provision extending coverage for adult children up to age 26.

"As a mother of a sick child, you are concerned whether your kid is 4 or 24," said Schley, an office administrator. "We couldn't wait for this to kick in."

Things are working out for the Schleys, but the high-risk pools that provided the initial lifeline for Megan are faltering. Nationally, the latest count shows fewer than 12,500 people signed up, mainly because of waiting periods and high premiums.

Another mom with an uninsured daughter ran into a Catch-22 that illustrates the law's complexity.

Mary Thompson of Overland Park, Kan., was sure the law would finally let them get 11-year-old Emily on the family's health insurance.

Insurers had repeatedly rejected Emily due to a birth defect of the spine, surgically corrected when she was an infant. The law requires insurers to accept children regardless of pre-existing health problems, a safeguard that will extend to people of all ages in 2014.

But because Emily's father is self-employed and the family buys its own coverage, things didn't work out as expected.

Certain "grandfathered" plans selling individual coverage are exempt from the law's requirement to cover kids. The Thompsons' plan was one. That meant they would have to apply for a whole new policy, and the mother, a breast cancer survivor, was unlikely to be accepted.

"We would have had to start over with me — and I can't start over," said Thompson. A social worker helped get Emily into Medicaid.

In neighboring Missouri, an insurance company's campaign to get small businesses to sign up by taking advantage of new tax breaks has yielded mixed results.

One of the chief promoters of the idea is Ron Rowe, an executive of Blue Cross and Blue Shield of Kansas City. With some 150 previously uninsured businesses offering new coverage, his company's efforts earned the praise of Obama administration officials. But Rowe says many business owners found the math didn't work for them.

"The longer this has been out in the marketplace, the less appealing it's been to small-business owners," he said. A typical employee with 10 workers would have to pay about $31,000 a year for health insurance and recover only 10 percent to 15 percent of that through the new tax credit.

Rowe says his company is getting more interest from business owners by offering a cap on rate increases.

No group is more sensitive to medical costs than senior citizens, whose votes are also critical to Democrats' chances in the 2012 presidential election. So far, alarms that Medicare cuts would compromise their care have not been borne out. But Democratic lawmakers engineered the cuts to take effect gradually, while new Medicare benefits are being provided up front.

Topping the list this year is a 50 percent price cut on brand-name prescriptions for Medicare recipients who fall into the coverage gap called the "doughnut hole." Daniel Wisniewski, a retired truck driver from Staten Island, N.Y., reckons that will reduce the price of one of his heart drugs from $234.99 a month to around $117.

"I'm not much on politics, but I feel that that's got to help me," said Wisniewski, 69. "I worked and paid into Social Security for 55 years. When I was a kid I used to wash dishes in a bakery after school."

Republicans say such gains will be temporary. For families, "any marginal benefits from this law are far outweighed by the heavy-handed intervention in their health care by Washington bureaucrats," said Sen. Orrin Hatch, R-Utah.

One of the principal authors of the bill, Democratic Sen. Max Baucus of Montana, says he laments not devoting more attention to cost control up front as lawmakers worked to expand coverage. "It gave detractors an opening," he said.

[babooph]

Best to stop health care for the lower classes-there are too many of them any way& bankrupting them when they get costly treatments keeps them working & off our golf courses...

[AnneNYHI]

With all that's being said about the health care reform, it's hard to tell what it's really about. Both parties are presenting facts and figures on how the law will impact our health and even our lifestyle.Some testify on how it has helped their family while some say that it's costing them even more. But this is what I think - health care costs are going to increase with or without the health care overhaul. So I'll go with the the reform 'coz here steps are made to improve the care that I'm going to get and health care for me is guaranteed even when I get sick. The costs come with more health benefits and more access to it.

Anne C
NY Health Insurer

[afmcalax]

The one argument I never hear about with America having universal health care is how it would actually free people economically and create a huge rush of entrepunerial energy. Imagine if you and the members of your family were automatically insured with health care. How many people would leave dead end jobs and create new businesses, new technologies, and help America regain its leadership role? How many people would overcome medical conditions and become productive members of society and the corporate world? How many people stay in poorly run organizations because their need for health care overrides their ability to take a better idea and create a new industry or do what they are currently doing even better? People need to realize that if health care was divorced from the work place and just made a universal part of society, American businesses would be freed of huge financial responsibilities and would compete on equal basis with each other instead of trying to gain the competitive edge by deciding whether they can afford to provide health care. People are thinking small and thinking divisive; but universal health care could be the greatest positive economic force America has ever created if done right!

[Zann-Zel]

That makes a lot of sense! : )

[afmcalax]

My understanding is that there is a large group of Americans that support the current health care reform; there are even a larger group that suppport the current health care reform but recognize the need for improvements in cost containment and affordability; there are actually a minority of Americans that actually want health care reform to be repealed completely and a return to the current situation where health care is becoming increasingly unaffordable; unavailable to those with pre-existing conditions; cancelled once a person has the audacity to file a claim; or lieaves so many without converage while still being the most expensive system in the world. If Republicans and the Tea baggers have improvements and alternatives let's hear them, but so far 8 years of Bush - Nothing; 2+ years of Obama - Nothing either! The party of NO has no answers.

[elliesamericana]

As time goes by more people will see the merits of affordable healthcare. The resistance we see to it is political agenda and not what is best for the country. Hopefully, it will be a first step towards true health care for all in America. Stop and think of Christian values? Do you really want your fellow citizens denied healthcare? We need to keep pressing forward and adopt a medicare style system that covers ALL Americans. Once all have access to decent care the system will be fair. Respectfully, retired US Army Medical Officer.

[Doctor_Bones]

The thing that amazes me is how the corporations that have no interest in people whatsoever seem to attract it's defenders from the very people that the corporate machine despises, the corporation exist to serve itself ( the board members and investors) and has no use for you except for your dollars.

I don't know the psychology of it all, but, I am amazed at the liberal vs. conservative responses to these issues.

Maybe socialized medicine is not right for corporate America, so be it, but, an uncontrolled corporate insurance mafia is not the answer either.

[bantamei]

Republitards seem to be proud of their ability to tell the most outrageous lies. They love to misrepresent healthcare overhaul as "Obamacare" but never mention "Romneycare".

[mb91764]

What that I heard,"we are from the goverment and we here to help you."A few years from now we want be able to drive to work,eat heath food,or still be able to pay for our heathcare.Look on the bright side at less wall street,banks,the super rich will be doing great.Hey, lets protest those NFL owners,making those players work like slaves,have buy there on heathcare too.

[afmcalax]

A few years from now when companies abandon health care just as they abandoned pensions and you are without the ability to get health care because of a pre-existing condition or just your age makes you uninsurable, you will see the short-sightedness of your current argument. Our current delivery system is fatally flawed. We either reform or in less than 10 years the market will force American companies to eliminate this benefit to stay in business and then we will all have 3rd world health care.

[cepe10-2009]

LOL at senator Hatch of Utah - the regulators are nothing compared to the corporate warlords and their libraries of inconsistent rules and policies, facsist organizational structures - all aimed at making them unaccountible and stealing money from the masses. Hatch is just sad his crony fat cats may not be able to make as much money

[Zann-Zel]

If this law just took an ounce of control away from Insurance companies I'm happy!
In order to breath I need to take Allegra-D - I used to get it for $10 with my insurance plan, then it went up to $25 then it went up to $50, THEN my insurance company simply said they wouldn't cover it at all! And in order to get it I would have to pay $150 for a 30 day supply! Even with a Letter from my doctor I couldn't fight their decision! They are in Total Control! So for 2 years I had to go without it. This week Allegra went over the counter and I bought a box for $11 - a 30 day supply would cost me only $33. There is definately some Scamming going on when the price of 30 pills can fluctuate from $10 to $150!

[notyrants]

The objective of the non-democratic corporate health insurance cartel is to take your money or the taxpayers money and not give it back. This pays the CEOs and CFOs and it pleases the stock market.

[Zann-Zel]

Exactly! And if some of us can't breath while they're doing it they couldn't care less!