Your Stories, Breaking Through: What the #ACAMeans to PA Families

The Supreme Court will hand down their decision in just a few hours. Will they put our health care back in the hands of big insurance companies? Or will they uphold our landmark law that is already saving lives, saving folks money, and putting all of us back on solid ground. 

Here are just a few of the stories and comments from folks across Pennsylvania who need the protections, choices and security the Affordable Care Act brings for all of us:

The Affordable Care Act means I can rest assured that my daughter will get affordable health care insurance. --Kathryn, Reading

It means I don't have to worry about the 'lifetime caps' from my healthcare insurance plan--as I have to deal with all of my health issues resulting from medical error ten years ago. --Barbara, Philadelphia

It have access to healthcare for my 21 year old who works part time and has no health care thru his work. The Affordable Care Act also means that women have more access to health care. Shame on those people who seek to destroy it. Many more Americans will die or get sicker without this. --Pat, Girard

It means that we have no more "donut holes" to worry about, that myself, my husband and my 2 daughters and our granddaughter can have reasonable health care coverage without worrying that the insurance company can refuse us even though we have previous conditions!!! --the King Family, Yardley

It means my son can be insured even tho he has a pre-existing condition. --Chris, Baldwin

Share what the #ACAMeans to you here, or by using that tag on Twitter. You can also head on over to our Facebook page and tell us there!

And in this morning's Post-Gazette:

June 28, 2012 12:00 am

By Nikita Lalwani / Pittsburgh Post-Gazette 

Beryl Trauth-Jurman can list his daily medications seemingly without thought: Imodium, Levsinex, Entocort, Prilosec, Zantac, folic acid and iron.

And those are just the mild drugs, said Mr. Trauth-Jurman, 23, who was diagnosed 10 years ago with Crohn's disease, an inflammatory bowel disorder. He also takes Methotrexate, a chemotherapy drug that modifies his immune system, and Cimzia, a drug injected biweekly to heal intestinal swelling.

Like many others with expensive medical bills -- and countless doctors, insurers, lawyers and politicians -- Mr. Trauth-Jurman anxiously awaits the Supreme Court's decision on President Barack Obama's health care law, expected today. Technically ruling on three separate cases involving four challenges to the law, the court will either uphold the law in its entirety or throw out parts or all of it.

The court also will affirm or deny the constitutionality of the individual mandate, which requires most people to have health insurance or pay an annual penalty.

If the mandate is found to be constitutional, it will take effect as planned in 2014. If not, the court will decide whether the mandate can be separated from the rest of the law or whether more or all of it will have to go.

Opponents say Congress does not have the authority to require individuals to buy insurance and that the law places an unfair financial burden on state governments. Those who support the law say it provides health care to those who need it most and that the individual mandate can be regulated as part of interstate commerce.

For Mr. Trauth-Jurman, the stakes are high. Although medication such as Imodium can be bought at low cost over the counter, a drug like Cimzia costs roughly $2,000 per dose. With insurance, Cimzia costs him just $70 -- and, thanks to the health care law, he is covered by his parents' insurance until he is 26 and guaranteed coverage after that, despite his pre-existing condition.

"It's frustrating," Mr. Trauth-Jurman said of the possibility of a full or partial repeal. "I don't know where my disease will be five or 10 years from now. If I'm uninsured, I wouldn't be able to afford the medication that does the most for me."

If the court strikes down the mandate and its related provisions, insurance companies can legally deny applicants coverage based on their health. If the entire law goes, many of its central reforms -- extended coverage for young adults, free preventive care, Medicaid expansion and Medicare discounts -- will no longer be enforced.

Barbara Dickman, 76, of Delmont will be among those to lose their Medicare discount if the court overturns the whole law.

Ms. Dickman, whose adult-onset diabetes has led to complications including congestive heart failure and sleep apnea, is currently in the Medicare "doughnut hole," a coverage gap in which beneficiaries are financially responsible for the full cost of their prescription drugs until they pay over a certain threshold.

Under President Obama's health care law, Ms. Dickman received a $250 rebate to help her pay for insulin in the doughnut hole. If it stays, the law would phase out the coverage gap completely by 2020.

"Was I saving money because of Obamacare? Big time," she said. "Last year I got out of the doughnut hole in October, and this year I might come out by July."

If the law is entirely overturned, Ms. Dickman may not be able to pay for her insulin, which costs roughly $500 a month. Now retired, she lives off of Social Security checks and a small monthly pension of about $125.

A few insurance companies, including UnitedHealth Group, Humana and Aetna, have said they will continue to offer some of the law's popular provisions if the act is overturned, such as free preventive care services and coverage for dependents up to age 26.

Aaron Billger, a spokesman for Pittsburgh-based insurer Highmark, said the company would honor all of its health insurance contracts regardless of the court's decision.

"If you are currently on your parents' coverage and your contract doesn't end until December, we will uphold that arrangement until then," he said. "We're watching the court closely to see where we will go from there."

But Bret DeLone, a general surgeon in Camp Hill, said he worries a national health care law will indirectly allow medical decisions to become the purview of the federal government rather than doctors and patients themselves. He said he also feels that the individual mandate is an unjustified expansion of federal power.

Like others in the insurance industry, Mr. Billger said he hopes the court either keeps the whole law or throws it out entirely.

If the court severs the individual mandate from the rest of the law, all but the sickest would leave the insurance pool, he said, causing prices to skyrocket.

The court extended its term from Monday to decide on the health care law, originally passed by Congress in 2010. The court heard three days of oral arguments in late March. The decision expected today is widely considered the court's most important in over a decade.

Nikita Lalwani: nlalwani@post-gazette.com or 412-263-1601. 

First Published 2012-06-28 00:25:56