Anthony Masker has a health insurance plan called hope.
“I guess I hope nothing severe happens,” said Masker, 50, of Syracuse. He works seven days a week driving a taxi. “I’m just trying to stay healthy.”
Masker is among the 49.9 million Americans — including about 46,000 residents of Onondaga County — without health insurance. He is also among the 30 million Americans who would be required to buy health insurance under the landmark health care law pushed by the Obama Administration and enacted by Congress in 2010.
But the fate of the law — and the nation’s uninsured — is in limbo as the U.S. Supreme Court waits to rule on the law’s constitutionality. That’s anticipated in March.
Some statistics on the national and local issue of those without health insurance:
- The percentage of Americans with health insurance through their jobs, according to the Census Bureau, is at an historic low: 55.3 percent.
- Nationally, the percentage of Americans without health insurance is a little more than 16 percent, according to Census data. Most are workers, like Anthony Masker, in service jobs that do not include health insurance benefits, say experts.
- Statewide, around 14 percent of the New Yorkers are uninsured.
- In Onondaga County, about 10 percent of residents lack health insurance.
The percentage of those uninsured, locally and nationally, has spiked in recent years because of the recession, said Sara Holmes, an administrator in the county health department. But Onondaga County, she said, is better off than a lot of places.
“We are not one of the worst counties,” she said. And for the 10 percent without insurance, the county provides free or inexpensive clinics through groups like the Poverello Health Center and the Syracuse Northeast Community Center, she said. Free clinics range from cancer screening to rabies and tuberculosis testing.
To extend coverage to more Americans, the new health care law would:
- Extend eligibility for public health insurance to those whose income is 133 percent of the poverty rate. That would be $29,300 for a family of four in 2011.
- Provide some coverage, free or subsidized, for all children under 18 and require companies who offer insurance to cover their employees’ children until age 26.
- Force insurance companies to cover those with pre-existing conditions.
- Require all Americans buy health insurance by 2014 or face a fine, unless they prove they cannot afford it. That requirement is called the “individual mandate” and it’s at the heart of the political and legal controversy over the law.
To keep the cost of insurance reasonable for individuals, said Grant Reeher, a political scientist at Syracuse University specializing in health care policy, state health exchanges will compile a menu of health insurance options for individuals. And governments will regulate those options to make sure co-payments or other costs don’t become unaffordable. Low-income families will also receive a hefty tax credit to help pay their premiums.
But the law’s effectiveness still faces some major challenges:
- Loopholes
Some Americans will slip through the cracks and remain uninsured, Reeher said. For example, some people, like the homeless, won’t become insured because they aren’t “functioning members of society,” he said. He added, “This isn’t going to magically provide that all people can afford health insurance.”
- Supreme Court’s Ruling
The hearing will likely start in mid-spring and the court will issue its ruling in June. The court will address specifically the individual mandate and if Congress overstepped its legislative bounds by obliging people to buy health insurance.
“Constitutionally, can you make somebody buy something?” said Jeff Stonecash, a political science professor who’s focusing on the health care law in his American government course.
He and SU political scientist Grant Reeher offer opposing predictions of what the court will do. Stonecash predicts the individual mandate will be overruled. Grant predicts the law will stay intact.
Either way, both experts agree the individual mandate is a central part of the law. Insurance companies have argued that large numbers of healthy people must pay for coverage so that the insurance companies can afford to also cover those with chronic ailments and pre-existing illnesses.
- State Lawmakers
In conservative regions, some lawmakers are vehemently opposed to the health care law and states have delayed looking into the health care exchanges until the Supreme Court has ruled, Stonecash said.
The law is deeply divisive along party lines. In the health care debate of the Clinton administration in the 1990s, Republican members of Congress advocated an individual mandate requiring Americans to buy insurance, while Democrats then wanted to require employers to provide coverage.
Now, Republican states are resisting the law and its individual mandate strongly, said Stonecash. The Supreme Court case has become an excuse to wait, he said, and that will slow down or complicate the health exchanges that are meant to help individuals and small businesses choose health insurance.
For Syracuse taxi driver Anthony Masker, the prospect of buying his own health insurance is more cumbersome than helpful. Masker wakes up everyday around noon and works until 5:30 a.m. The prospect of a car accident doesn’t faze Masker. And he hasn’t seen a doctor in the past five years, maybe longer.
“I’m healthy. I eat salads. I don’t eat fast food,” he said. “I don’t need someone telling me I need health insurance. I’m my own person.”
(Beckie Strum is a senior majoring in newspaper journalism and Middle Eastern studies.)
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