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Supreme Court Decision Means We’ll All Have Health Insurance Soon — But I’m Terrified

By carolyncastiglia |

obamacare legal, obamacare supreme court, healthcare law upheld, individual mandate upheld, free healthcare

So true, my friend. But is Obamacare really going to help?

Yes, it’s true. “The U.S. Supreme Court upheld the core of President Barack Obama’s health-care overhaul, giving him an election-year triumph and preserving most of a law that would expand insurance to millions of people,” Bloomberg reports. Exciting news, right? But wait — “The justices, voting 5-4, said Congress has the power to make Americans carry insurance or pay a penalty. That requirement is at the core of the law, which also forces insurers to cover people with pre-existing health conditions.”

Those of us that have supported the idea of a national healthcare system all along have used the fact that insurers could deny folks with pre-existing conditions as a major argument as to why Obamacare is so important. But there’s a caveat that comes along with today’s decision: “The court limited the law’s extension of the Medicaid program for the poor by saying the federal government can’t threaten to withhold money from states that don’t fully comply.”

Okay, so let me get this right. According to the LA Times, “the government may impose tax penalties on people who do not have health insurance,” but it won’t “withhold money from states that don’t fully comply” by offering aid to people who need it? Cool, so like, nothing’s really different then, right?

Look, I am one of the many, many, many Americans who makes juuuuuuust enough money not to be considered destitute but who does not make enough money to live on. I have debt, I have no insurance, I work my butt off. As much as this is a victory in some ways, it’s not like the Supreme Court upholding Obamacare today suddenly turned capitalism on its head and made the dreams of the Occupy movement come to fruition. Now I’m just another broke lady without insurance who HAS to buy an insurance plan which will hopefully be affordable, or I’ll have to pay a tax penalty. I’d like to think I make so little I’d be given free healthcare (really what we all naively and blindly assumed Obamacare was promising to those of us, oh, under 50…) but I’m not going to hold my breath. Once again, we’ve set up a system where corporations and the government benefit and face no repercussions essentially by not complying with the part of the law that really matters: helping poor people stay well.

From Bloomberg:

Chief Justice John Roberts, a Republican appointee, joined four Democratic-selected justices to give the president a majority on a law that has divided the country along ideological and partisan lines throughout his presidency. Roberts, writing for the court, said Congress had the authority to impose the insurance requirement under its power to levy taxes. ”It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income but choose to go without health insurance,” Roberts wrote.

That’s me. I don’t have insurance, and I go to therapy every week. (The single most important health and life decision I’ve ever made!) I pay out of pocket for my sessions at a sliding scale rate. Once I’m forced to pay for insurance, no matter how affordable, I will presumably still have a co-pay for those sessions. What if the insurance rate plus the co-pay is actually more than I’m paying now? I can’t really afford it as is, but it’s been so essential to my recovery from a very traumatic marriage/divorce (not to mention the childhood that led me there) I see it as an important investment in my future and my daughter’s as well. Isn’t Obamacare supposed to be making things easier for people like me? I hope it does. I really hope it does.

I went to the Edinburgh Fringe back in 2009, and I remember people cracking jokes about how it was cool if you got hurt in Scotland because you can just walk into a hospital, be treated, and walk out without worrying about having to pay an astronomical bill. (Because there is no bill at all.) I realize America is too big probably to provide free healthcare for all of its citizens, because wealthy people just don’t want to pay those kinds of taxes, but I worry that Obamacare is going to end up hurting the people it’s supposed to help, charging lower middle class people an insurance rate they can’t afford. I mean – where are the details: who do we buy insurance from? How much can they charge?

David Horsey of the LA Times wrote this morning, “The Supreme Court is shaking up the political chessboard today by ruling on the constitutionality of the Affordable Care Act – a.k.a. “Obamacare” – and there is one player who will win no matter what the decision may be: the insurance industry.”

According to this helpful sheet put together by the Health Foundation of Greater Cincinnati, the individual mandate doesn’t apply to you if “the cheapest insurance available to you costs more than 8 percent of your income.” That would indicate to me that someone in my position could probably expect to spend 10% of their monthly income on insurance. But that’s a lot of money when you make what I do, and that’s for the cheapest plan with probably the worst coverage and the highest co-pays. Hooray!

I know I’m jumping the gun here, and I really should just wait and see what happens as things unfold. After all, I have until 2014 to figure all of this out. In the meantime, I’ll be hoping that the million dollar deal I’ve been waiting for comes through so that I’ll be able to afford therapy. Because God knows life sure is stressful when you’re broke.

Photo Credit: SEIU International/Flickr

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About carolyncastiglia



Carolyn Castiglia is a New York-based comedian/writer wowing audiences with her stand-up and freestyle rap. She’s appeared in TONY, The NY Post, The Idiot’s Guide to Jokes and Life & Style. You can find Carolyn’s writing elsewhere online at and The Huffington Post. Read bio and latest posts → Read Carolyn's latest posts →

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0 thoughts on “Supreme Court Decision Means We’ll All Have Health Insurance Soon — But I’m Terrified

  1. Juliet Jeske says:

    I was denied coverage when living in Illinois due to bogus “medical” reasons by a large insurer. I fought this nonsense for years and finally got insurance when I was hired at a large non-for-profit. These companies don’t like insuring individual plans because they aren’t cost effective, so they make excuses and find loop-holes and lose your paperwork…it just doesn’t stop. In nearly every state a person can be denied for health reasons, and Obamacare will stop that practice. But I would agree this is hardly a perfect solution, and for me it won’t get better until we have single-payer or a system that is closer to those in Europe. I have heard the rhetoric on the right, but I know the hell that I have been through. Our health insurance system is broken and getting worse every year. This reform doesn’t do nearly enough but at least it is a step in the right direction. Don’t even get me started on CEO’s of health insurers making $30 million a year, it just makes me sick. And I mean that literally.

  2. Meagan says:

    Small steps. :-/ People WILL be hurt by this law, and when enough people are hurt, it wil be revised and adjusted so fewer people are hurt, and then again, until we end up with something that’s not GOOD exactly, but doesn’t suck enough to push people to act against it. I realize I sound sort of pesimistic, but I think this is just how these sort of things work, and it’s a step in the right direction to eventually make things better for everyone. It just takes a while, and it’s no comfort at all when your family is one of the ones to get hurt.

  3. Robert Keller says:

    This is no doubt a complex issue, but Obamacare and its being upheld by the Supreme Court today is undoubtedly a step forward. And I believe that low- and middle-income earners will, all in all, be better off, especially those like yourself, who do not currently receive health insurance coverage through an employer. As the New York Times reported today, low- and middle-income earners will receive a subsidy for the insurance coverage that they are mandated to purchase. For more details on how this will actually work in practice, check out According to Obamacarewatch’s figures, a family of four who does not qualify for Medicaid but earns no more than $88,000 annually will receive a subsidy. And the lower your income, the greater the subsidy, from what I gather. That seems fair.

  4. carolyncastiglia says:

    Thanks for the links, Robert. I’ll check ‘em out.

  5. Megan says:

    I wonder if it’ll be like the kids care program we have in az. Those that don’t qualify for Medicaid but still make under a certain amount can pay a $50 monthly copayment for all of their children to be covered. Once that copay is made, they actually are given Medicaid. No other copays. Same benefits as Medicaid and is billed the same.

  6. Amanda says:

    I wonder if liberals will be as thrilled with this ruling if at some point in the future, a GOP congress and president decide to “tax” people for not purchasing something on the private market that they deem essential. Regardless of how one feels about the specific provisions in Obamacare, I think that we should all find it troubling that SCOTUS has decided that the federal government now has unlimited power to tax individuals for NOT participating in commerce.

  7. Wesley says:

    Am I crazy for thinking that not only is no one entitled to free health care in this world, but that living in a country of that much entitlement would be monumentally detrimental to its makeup?
    I mean, I actually read you write the words “Now I’m just another broke lady without insurance who HAS to buy an insurance plan which will hopefully be affordable, or I’ll have to pay a tax penalty. I’d like to think I make so little I’d be given free healthcare.” Where does this kind of entitlement come from? I’m not being cynical – I’d really like to know what makes people think healthcare is suddenly an unalienable right we shouldn’t have to pay for.
    I actually support the ACA in large part because of this tax penalty proviso. Yes, the ACA is a lesser of two evils – the greater evil being broke-as-a-joke people dying on the streets because they can’t pay for healthcare – but a plan that actually incentivizes people to take personal responsibility through the consequence of a tax penalty and the provision of affordable/free healthcare and fair coverage is something I can support.

  8. tanya o'debra says:

    I saw on the news that only 6% of Americans will be affected by the mandate, but I guess we’ll see…

  9. nessie says:

    I lived in England for 4 years and had my daughter there. Trust me, we don’t want their healthcare system. You get what you pay for.

  10. Rosie McPosie says:

    To clarify on the point that the government can’t withhold funds from states who don’t comply, I wanted to add that they actually can “decrease” funding by way of limiting any fund increases. States who choose not to follow the new rules won’t get any fund increases – they won’t lose their current fund rate (which is the main thing the justices wanted – to preserve current levels). But. They also won’t see increases. And in this economy, they are going to need those increases. So, you will likely see the states fall in compliance in the next couple of years. They may squack, but at the end of the day, they need the fund increases. Bad.

    Also, another important thing to note is the increase in eligibility for Medicare/Medicaid. The rate of income is now 130% (I think the percentage is closer to 136%, but I’ll be conservative) of the “poverty line”. That is going to allow for many, many more people to become eligible.

    We have to start somewhere – and I personally feel this is a great place to start. Disallowing insurance companies from discriminating based on pre-existing condition status is a HUGE step in the right direction. Especially for parents who have sick children. This is a win!

    Light at the end of the tunnel, light at the end of the tunnel!

  11. Ima Student says:

    What about those who are students in college? I love the idea of having health insurance, but I am in no way going to be able to afford insurance. In fact, I had to drop my insurance plan after I began school because I couldn’t afford it. I am a full time student who takes 15+ credit hrs and an internship EVERY semester, as required by my college. I do not work because my school schedule seems to be an issue with every interview and financial aid is never going to cover all I need plus insurance (I in fact run out of financial aid before the semester is up), so how will this affect students like me?

  12. lani says:

    I’m glad. It won’t effect us, except that my oldest daughter who will be 18 the end of the year, will get to stay on our insurance plan until she’s 26. That was our worry. She has a disabilty, and she needs physical therapy 3 times a week. It is a win for us who have sick kids. For that I’m grateful.

  13. Christina says:

    I heard on CNN the tax penalty will only be $200,and there is a mandate that the IRS can’t collect it. My kids currently qualify for Medicaid and while its not perfect its a godsend for us w/ my son’s developmental delays. The worry is that so few drs accept it,and w/ more patients,possibly less payments to drs…quagmire all around.

  14. Tammy says:

    Megan – I live in AZ. The Kids Care program has been capped for the last few years – taking no applicants and allowing many to age out. Only in the last two months has it started allowing people to apply again. If you are poor and live in AZ, you are kinda screwed.

  15. goddess says:

    IMASTUDENT: Aren’t you on your parents plan? You can reamin so until 26 or so (not sure on the exact year)

  16. Jelena says:

    To Wesley,
    So…no one is entitled to free healthcare in this world, is that correct? No one? Really? What about children? What about sick children? Are THEY responsible for paying their way? Towing the line? Socialized healthcare exists already. It exists for veterans, the military, congress members. These people do not pay for healthcare? So…only CERTAIN people deserve free healthcare? Its not a matter of entitlement, its a matter of common sense. The same way that we have access to free education in this country. For a nation to be competitive and strong, it is in that nation’s best interest to have a population that is healthy and well-educated. NO, we are not ALL entitled to drive BMWs, live in nice houses, wear high fashion, eat the finest foods, etc…but yeah, sorry, I DO believe that our government should provide a certain basic level of care for its people. We pay taxes, we are a community! If you want it to be strictly every man for himself, go live on a damn island somewhere. No one should have to choose between their health, or the health of their child, over things they need for survival. Im so sick of hearing that argument about entitlement. Not EVERYTHING should be commodified!

  17. Robyn says:

    Health care is a right, not a privilege. All human beings are entitled to it, even prisoners. My husband has a t-shirt with a quote from the Alcatraz rules and regulations: “You are entitled to food, clothing, shelter, and medical attention. Anything else you get is a privilege.”

    I agree with Juliet. However, I am afraid of what “affordable” will mean. I’m hoping that a system more like what people in France have will happen during my lifetime. This is one step in the right direction.

  18. Robyn says:

    Goddess: Not all parents have insurance. I can’t get insurance because of a pre-existing condition.

  19. Manjari says:

    What Jelena said!

  20. El says:

    To piggyback on Robyn…not all parents are working. Only the parents employer provided plans have to provide coverage to 26. My parents retired when I was 18. I had student health insurance as a result. Not cheap, and not good coverage. Sadly, the people I hear complaining the loudest, are the ones who will likely benefit the most and pay the least. (in my personal circle).

    I think this was a back door way to get people to agree to single payer. Make the free market doomed to fail ( by not having any real way to compel compliance since the tax isn’t truly high enough to force people to buy insurance and not collectible since the only method of collection of nonpayment is the ability to withhold refunds). In a few years they can say, “see, we tried the free market approach and it ended up not working. Single payer is the only option to ensure coverage and contain costs. People were even more opposed to Hilary’s single payer option during the Clinton presidency. This is just a different way to get there.

  21. Ann busceme says:

    Yes being poor and uninsured is stressful. But, god forbid, if you have a serious medical emergency your medical bills will end up being paid for by those of us with insurance, in the form of higher premiums, copays, etc. My family paid $8,000+ in health insurance premiums alone last year. My family can’t afford to pay more for health insurance either by subsidizing your decision to not buy insurance.

  22. Crystal says:

    wow… everything sucks.. I hate trying to make sense of all this… I will just take it as it come… with a smile.. 0.o

  23. Andrea says:

    If you think this doesn’t affect you, you could be wrong. Employers may drop their insurance benefits because the fines are cheaper than paying for coverage. In that case you will be forced to purchase your own insurance which could end up costing you more than you pay now. This website calculates what it means for you personally.

    I tried it and if my company drops insurance, what I pay will double, and at what level of service???

  24. Tammy says:

    Oh, you can afford a trip to Scotland but not health insurance for your family? Awesome!

  25. Guajolote says:

    Here’s a page with info about the financial help available to families not eligible for free insurance, but not able to purchase insurance outright:
    More on the Patient Protection and Affordable Care Act here:
    I for one am so relieved that my dad won’t have to leave the country to get his pacemaker battery replaced. Not sure how easy it will be for him to afford insurance either – but at least we have the option to try and get him insured now!

  26. Christina Gleason @ WELL, in THIS House says:

    My husband and I make enough money to be well above the poverty rate, solidly middle class. But our expenses are ridiculous – everything costs more in a solidly middle class surburban town where there is no public transportation and high speed Internet access is a necessity because it’s how I make my living – and we do find ourselves struggling when it comes to paying all the bills some months. BUT that’s not my point here. My point is that, for pretty much every year I can remember, we’ve gotten a tax deduction for health care expenses because the premiums alone – for my husband’s employer-sponsored health care plan – were higher than 7% of our combined income. I looked into getting insurance through our local Chamber of Commerce because I’m self-employed, and the premiums were even higher. I looked into getting an individual plan directly from the insurance companies – it was even higher. What I’m try to say is… if your finances are hovering just above the line where you could qualify for government assistance, I can almost guarantee you that you won’t have to pay any sort of penalty for not having health care because you’re not going to find a plan that costs less than 8% of your income.

    That being said, I hope your situation improves so you can get the coverage you need. I see my therapist every other week, and we ended up paying for all of my visits out of pocket ON TOP OF about $8,000 in premiums because we never met our $5,000 deductible. I’m still angry about that, but with all of my health problems, we couldn’t risk not being insured if something catastrophic happened. (Fears were high for that because my dad was going through cancer treatment at the time we had to make the decision to continue our insurance coverage.) But I wish, for you and your family, that you will find yourself in a place where you have the health coverage you need to ensure you are healthy and well for your kids.

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