Obama’s Complicated HealthCare Reform Goes into Effect

New challenges are confronting President Obama’s health care reforms as 2014 begins, and the main sections of the law go into effect. Just a few hours before the beginning of the New Year, a Supreme Court judge placed a temporary injunction on the mandate that makes it mandatory for employer-provided health insurance plans to cover the costs of birth control.

Justice Sonia Sotomayor’s decision coincided with a historic moment for the United States, as 6 million Americans found themselves with health insurance coverage for the first time, and it joins a long list of economic, legal and political challenges that the legislation has provoked since it was first proposed.

Jan. 1 was the designated implementation date for some of the most popular sections of the Affordable Care Act, which has become President Obama’s flagship policy. Insurers can now no longer refuse to provide coverage on the grounds of a pre-existing medical condition, a move that, according to the White House, will affect 129 million patients. It will also be illegal for insurers to place an upper limit on the medical costs they are prepared to pay for each patient and charge women more than men similar plans.

The White House has announced that more than 2 million Americans have purchased these plans through the new insurance marketplace, although some technical issues with the online enrollment process still need to be resolved. Among other consequences, the new law will make it possible for 6 out of 10 Americans, who are currently without health insurance, to purchase a policy for under $100. It is also hoped that hundreds of thousands of people will benefit from the extension of the federal Medicaid program for those on low incomes.

However, rather than celebrating these figures, the Obama administration must prepare an official response to Sotomayor’s ruling before this Friday, when she may decide to prolong the injunction so that the case can be heard by other justices, or — as the New York Times explains — the Supreme Court may decide to investigate the case immediately.

The lawsuit, brought by the Little Sisters of the Poor, a nonprofit that runs a home for the elderly in Denver, is one of many dozen cases brought against the federal government in response to the section of the legislation requiring businesses to provide insurance policies to their employees that cover the cost of contraceptives and other methods of birth control. Since the law was passed, businesses and organizations with religious affiliations have alleged that the government is forcing them to act against their beliefs.

Just before Sotomayor’s decision was announced, Archbishop Joseph Kurtz, from the United States Conference of Catholic Bishops, claimed in a letter to the president that the legislation “harshly and disproportionately penalizes those seeking to offer life-affirming health coverage in accord with the teachings of their faith.”

The complainants also allege that they face financial penalties that could jeopardize their survival. A key aspect of the new legislation is that Americans must either take out medical insurance or pay a fee when they complete their next tax return. Companies that provide health insurance directly to their employees must ensure that the plans cover birth control; if religious groups fail to do so, they will be liable for paying a fine.

Planned Parenthood, a coalition of organizations that provide medical care to millions of American women, responded that the process of enforcing the law must continue. “Religiously affiliated organizations … are already able to get an exemption so that they aren’t paying for or administrating coverage of birth control if it violates their religious mission,” said the group’s president, Cecile Richards, in a statement. “This exemption ensures that women can get access to affordable birth control no matter where their work, while also addressing the concerns of religiously affiliated organizations.”