How health care law affects lives of 5 Americans


As the U.S. Supreme Court prepares to hear arguments on President Barack Obama's health care overhaul, The Associated Press spoke with a variety of people to hear their experiences so far with the landmark legislation, whose major provisions don't take effect until 2014. Reporters asked: How has the health care law affected your life?

Name: Glenn Nishimura Home: Little Rock, Ark. Age:
(Credit: AP, 2011)

Name: Glenn Nishimura
Home: Little Rock, Ark.
Age: 62
Occupation: Consultant to nonprofit groups.
Insurance coverage: Uninsured since COBRA coverage from a previous job expired in May of 2009.

Nishimura has been uninsured for nearly three years. He lost his health coverage after he left a full-time position with benefits in 2007, thinking he could land another good job. The recession destroyed that plan.

He's been denied coverage because of high blood pressure and high blood-sugar levels. A provision in the national health care law gave his state $46 million to insure people like him who've been denied coverage because of pre-existing conditions.

But Nishimura said he can't afford the coverage. It would cost him about $6,300 a year in premiums with a $1,000 deductible, meaning he would pay the first $1,000 out of his own pocket before coverage kicks in.

He worries about suffering injuries in a car accident or falling ill before he's eligible for Medicare at age 65.

"I don't like feeling vulnerable like this," Nishimura said. "I'm completely vulnerable to some catastrophic problem."

Nationally, about 50,000 people with pre-existing conditions have signed up for the coverage available through the health care law, fewer than expected. The government has offered new options to encourage more to enroll. In another two years, he may be eligible for subsidies under the law for insurance.

Name: Samantha Ames Home: Washington, D.C. Age: 25
(Credit: AP, 2012)

Name: Samantha Ames
Home: Washington, D.C.
Age: 25
Occupation: Law student
Insurance coverage: Got back on parents' insurance, thanks to the health care law.

As a teenager, Ames was prone to ankle injuries playing catcher on baseball and softball teams. Last April, she tripped over her mini bulldog and badly injured her left ankle. Ultimately she needed surgery that cost her insurer $30,000.

But she considers herself lucky.

Only a few months before her accident, Ames had been able to get back on her parents' insurance, thanks to a provision of the health care law that lets young adults keep that coverage until they turn 26. Nationally an estimated 2.5 million young people have gotten insurance as a result.

Ames says it's unclear if the student health insurance she had been relying on previously would have covered her surgery. In any case, the copayments would have been steep. She would have had to postpone the operation, risking another — potentially crippling — injury.

"The fact that I was able to get on their plan is the reason I can walk today," said Ames. "Very rarely have I had something political affect me this personally."

Name: Sharon Whalen Home: Springfield, Ill. Age: 59
(Credit: AP, 2012)

Name: Sharon Whalen
Home: Springfield, Ill.
Age: 59
Occupation: Publisher of a weekly alternative newspaper
Insurance coverage: Small group plan.

As a co-owner of the Illinois Times, a weekly newspaper, Whalen wants to keep her small staff healthy. So she and her business partner provide them with health insurance and pay half the cost of premiums for their 10 employees.

Keeping that employee benefit is getting more and more expensive. The company saw a spike in premium costs after one employee's child had chronic health problems.

With costs climbing, the company switched to a managed care plan with higher copays for some services in 2009. Whalen's company also contributes less than it once did to cover the premiums of employees' family members.

The health care law brought some relief: a tax credit for small businesses that provide health coverage. The Illinois Times qualified and received a $2,700 tax credit last year.

"We see ourselves putting that money right back into the company," Whalen said.

Whalen heard about the tax credit from a health care advocacy group, not from her accountant.

"I had to practically beg them to look at this," Whalen said. "They weren't familiar with it."

The Obama administration has proposed expanding the number of businesses eligible for the credit, and simplifying the paperwork.


Name: David Zoltan Home: Chicago Age: 34 Occupation:
(Credit: AP, 2012)

Name: David Zoltan
Home: Chicago
Age: 34
Occupation: Field marketing coordinator for a public relations firm.
Insurance coverage: Federally funded health plan for people with pre-existing conditions.

Zoltan lost a job and his health insurance during the recession. His diabetes sent him to the emergency room three times when he ran out of insulin during the two years he was uninsured.

In 2010, he was one of the first to sign up in Illinois for a new health insurance program for people with pre-existing conditions. The Affordable Care Act set aside $196 million for the state of Illinois to start the program.

Zoltan now pays about $1,848 a year for that coverage. The plan has a $2,000 deductible, meaning Zoltan also pays that amount out of pocket before the coverage starts.

Zoltan has found work, but his new job doesn't include health benefits, so he'll stay on the federally funded health plan.

"As a diabetic, I never again want to be without health insurance," Zoltan said. "Anything is better than not having coverage at all."

He is watching the Supreme Court as it considers the law. The requirement that Americans buy health insurance is under constitutional scrutiny. Zoltan believes the individual mandate is needed to spread the risk among the well and the sick, and keep insurance affordable.

Name: Carol McKenna Home: Pembroke Pines, Fla. Age:
(Credit: AP, 2012)

Name: Carol McKenna
Home: Pembroke Pines, Fla.
Age: 70
Occupation: Retired.
Insurance coverage: Medicare Advantage plan.

McKenna and her husband Morty have noticed that Medicare's "doughnut hole" is shrinking. The coverage gap in Medicare's prescription drug program — dubbed the "doughnut hole" — caught Morty in December last year. But once there, he received a 50 percent discount on brand-name drugs and other discounts on generic drugs thanks to Obama's health care law.

Last year, he received a $250 rebate check provided by the new law for people in the doughnut hole. Under the health care law, the gap will be gradually phased out by 2020.

Warnings about possible cuts to Medicare Advantage plans caused by the health care law haven't come true, Carol McKenna said. Their health plan still includes extra benefits such as fitness center membership.

She said she's grown weary of the political debate over the health care law.

"I've been following it somewhat. Then it got so convoluted and out of control during the elections that I stopped paying attention," McKenna said. "I don't want to hear it anymore. All they're doing is sniping at each other."

Get the Newsday Now newsletter!

The best of Newsday every day in your inbox.

Sign up

By clicking Sign up, you agree to our privacy policy.

Comments now uses Facebook for our comment boards. Please read our guidelines and connect your Facebook account to comment.

By using this site, you agree to our Privacy policy.

Sorry to interrupt...

Your first 5 are free

Access to Newsday is free for Optimum customers.

Please enjoy 5 complimentary views to articles, photos, and videos during the next 30 days.