The new law offers basic health benefit for millions below poverty line without discrimination on age and health, and insurance subsidy to others above poverty line yet poor, among a total of the 30 million uninsured Americans. The poorest are just rushing for enrollment in the expanded Medicaid scheme where health service will now come free while the low-paid are queuing up for the Govt handout of insurance subsidy. There is also tax credit for small business at 50 per cent for providing low cost insurance premiums to the employees. The insurers have also been barred from turning away consumers with pre-existing conditions, a widely welcomed provision in Obamacare. America is buzzing.

The US began to move away from market-driven health care with the inception in 1965 of fringe benefit schemes like the Medicare and Medicaid that had been restrictive in enrollment. President Bill Clinton's proposal for universal coverage was rejected by the Republicans. Clinton's healthcare reform Bill had provided for a mandate for employers to provide health insurance to all employees through a regulated marketplace and it was blocked in 1993. In 2007, a Healthy Americans Act too failed. Healthcare facilities and pharmaceuticals are mostly owned and operated by the private sector in America and the industry lobby is powerful enough to thwart any pro-people legislation.

Healthcare reform was a major issue in the 2008 presidential election. Jonathan Gruber, a professor of economics at MIT, who was among Obama's presidential campaign advisers on healthcare issues, later helped draft the ACA. The Repubs opposed the individual mandate contained therein as unconstitutional in order to filibuster a legislation. The mandate pushes a requirement to buy insurance or pay a penalty.

The Supreme Court verdict that allowed the states to decide themselves whether to implement or not to implement the new Federal law within their jurisdiction, gave the the Repubs who had taken up cudgels against Obama a new opportunity to undermine the legislation, but alas, to the detriment of their own people, denying a large number of Americans the promised healthcare. According to a Kaiser Family Foundation estimate, 4.8 million people in those states will go without the new healthcare coverage because of the recalcitrant GOP. In these states, the old Medicaid will continue to remain limited to certain groups of people as earlier: those 65 and over, children, very low income parents, poor elderly, disabled, pregnant women.

It looks all the more unfortunate for those as the Federal government, under the new law, would have paid 100 per cent of the cost of the Medicaid expansion for four years and 90 per cent subsequently. While dispensing frugal medical treatment as stipulated in the old scheme, patients denied proper treatment on time end up in emergencies which by law have to be cared for, incurring more expenses, which could have been avoided, by these GOP states.

All citizens and legal residents with income up to 133% of FPL (Federal Poverty Level) (approximately $14,000 for an individual and $29,000 for a family of four) will qualify to enroll for expanded Medicaid and those whose incomes are between 100% and 400% of FPL will receive Federal subsidies for insurance cover. And those eligible but not taking up insurance are mandated to pay a penalty.

As one fills out a Marketplace application, the eligibility results come up, and one can find out about how to lower the costs on monthly premiums for those not covered under the expanded Medicaid and seeking subsidy for insurance cover. According to data supplied by the Federal Department of Health and Human Service, Washington, to www.indiatraveltimes.com, in order to qualify for lower costs (subsidy) on monthly premiums under the new law, one must have annual income that falls below:

• $45,960 for an individual
• $62,040 for a family of 2
• $78,120 for a family of 3
• $94,200 for a family of 4
• $110,280 for a family of 5
• $126,360 for a family of 6
• $142,440 for a family of 7
• $158,520 for a family of 8

However, the HHS was unable to answer our question as to an overlapping incidence for those in the range of 100%-133% of FPL.

The Obamacare philosophy postulates that national health contributes to national security and strengthens the country. But there has been a raging debate if the role of a Govt includes dispensing social medicine like in Britain and critics say such handouts will merely foster dependency, that it is a social welfare policy encouraging healthy people to become dependent on the State. (Highlights of American health care system - Then and Now)

-Editor