The Affordable Care Act, better known as Obamacare, is still a mystery to most Americans. Even many well-informed people do not know what it requires and what it offers, except for the mandate to have health insurance coverage. Attorneys on both sides of the issue argued last week in front of the Supreme Court about the constitutionality of the mandate.

Some of the act’s requirements have already been put in place, such as coverage for unmarried children, up to the age of 26, being included in the health insurance policy of the parents. Also, insurance companies can no longer turn down anyone for coverage because of pre-existing health problems.

Almost 40 million additional Americans will be covered under this new health care program. Insurance subsidies will be provided for low-income persons, the unemployed or underemployed, who previously lacked coverage. Also, preventive care will be covered completely, without co-payments. 

Before the new Affordable Care Act, employers were the main source of health insurance. Most employees had to pay some or all of the cost of their coverage, and millions of self-employed and other Americans had to buy their own health insurance. Also, the federal government deducts taxes from all wage earners, to support Medicare payments, which all citizens can eventually receive, at 65 years of age. 

For those without health coverage, states and the federal government have provided help through unemployment checks, food stamps and grants to communities. Almost all hospitals have been required to provide emergency services to indigents and immigrants, legal or otherwise, regardless of ability to pay, since 1986, under the Emergency Medical Treatment and Active Labor Act, signed by President Ronald Reagan.

The new health care law has been very controversial, especially because it forces people to buy health insurance or face a fine for not doing so. Our government will be compelling people to enter into a contract to buy health insurance, whether they want to or not. Most Americans with health insurance coverage get it through private insurance companies today.

In order to pay for Obamacare, and to keep Medicare solvent, Medicare benefits will be reduced in the future, most likely by raising the age of eligibility, taxing Medicare supplement plans, or limiting eligibility for high-income citizens.

Many people want to see the new health care law over-turned, because of concerns with the mandate to purchase health insurance.

Some others fear that they could be moved to a different doctor or clinic, and not be able to stay with the doctor of their choice. Some smaller medical practices might go out of business due to added expenses.

Those who support the new law believe that we all pay for the poor to be treated, one way or another. When people without health coverage get sick, they often wait until their condition gets serious before seeking treatment, and then go to hospital emergency rooms, which are very expensive. If they had coverage, and saw a doctor sooner, the cost would be much lower.

When hospitals give free care, they still have to pay for their staff and supplies. To recover those costs, they charge higher fees to their paying customers, or their insurance companies.

Some legal experts believe the Supreme Court will change parts of the health law or even overturn it when its verdict is rendered this coming June 2012. The health care law is more than 1-1/2 years old now, and it is facing its first major constitutional challenge.

Supreme Court justices have wrapped up oral arguments on the constitutionality of the Affordable Care Act. The decision of the court is likely to be decided by a 5-4 vote, according to many legal experts.

If it is upheld, a lot of administrative details will have to be developed. A win could help the President’s re-election chances, because it would show that his judgment on the constitutional issues was correct. But, if it is overturned, it could severely damage the President’s campaign.

The health care issue has wide-reaching effects on personal and commercial freedoms, higher taxes and regulations that control consumers and businesses alike. It will be interesting to see what the Court decides.

— Bernard Featherman is a business columnist for the Journal Tribune and former president of the Biddeford-Saco Chamber of Commerce.