Published March 21, 2011
President Obama signed into law the overhaul of the nation's health care system a year ago this week, and most of the early provisions of the new law were the least controversial and those most likely to be welcomed by voters. They are what critics call sweeteners -- changes in coverage that were simply dictated to insurance companies.
"Young people can now stay on their parents' plan until they are 26 years old," House Minority Leader Nancy Pelosi, D-Calif., said. "[That] seems to be one of the best known and most popular parts of the bill."
Insurance companies were also told they could not deny coverage to children with pre-existing conditions, impose lifetime limits on benefits, cancel anyone's coverage or charge a deductible or co-pay for preventive services such as mammograms and colonoscopies, among other things.
"Prevention is being pushed and promoted across the country. That's a big change," Health and Human Services Secretary Kathleen Sebelius said.
But critics say there's no free lunch and that adding benefits increases the cost of insurance.
"We put a huge number of new mandates on what insurance has to cover and then tell people they're not going to have to pay anymore for it and we're already learning -- it can't work," says Grace-Marie Turner, president of the Galen Institute and author of the book "Why Obamacare Is Wrong for America."
But many Democrats continue to tout its impact.
"This legislation is about, of course, improving quality, lowering costs and expanding access," Rep. Pelosi says.
However, the public remains skeptical. A new Kaiser poll finds 46 percent of Americans view the law unfavorably, while only 42 percent have a positive view.
Republican Senator John Barrasso of Wyoming says, "when Nancy Pelosi said 'first you have to pass it before we know what's in it,' month to month people are finding out what's in it and they don't like what they see."
And there’s another snag. So many plans are unable to meet even the early requirements of the law, the administration has been forced to grant more than a thousand waivers to companies, several labor unions representing everyone from teamsters to electrical workers to plumbers to carpenters, and even whole states such as Maine.
"When the 2.5 million Americans are given waivers so that health care law doesn't have to apply to them, half of America is saying, 'Hey, I don't want it to apply to me either, '" Sen. Barrasso said.
Lawmakers from both parties are in the process of repealing one provision even the president conceded was too big a burden on small business.
That required businesses to keep up with every single health-related expenditure and add them all up at the end of the year. Then, they would have had to file what's known as a 1099 form on anyone to whom they paid more than $600 over the course of an entire year.
There was broad bipartisan agreement that requirement was too burdensome. The only reason it was in the bill in the first place was to add theoretical revenue from anticipated increases in tax collections to make the overall bill look less expensive.
Over the past year, more than 20 states have challenged the constitutionality of the law. The courts ruled both ways, some saying it is constitutional, some saying it isn't.
Many states want an expedited review by the Supreme Court to resolve the uncertainty because of all the preparations they'll have to make if the law is upheld and does not get repealed, though the Obama administration opposes an expedited review.
Sen. Orrin Hatch, R-Utah, agrees there should be an expedited review.
"I think the court has to take that case," Hatch said. "It should take it sooner rather than later."