After the Supreme Court issued its 5-4 decision upholding President Barack Obama's signature Affordable Care Act, state governments would have to figure out how to comply - or not - with the federal law.
Although conservative Chief Justice John Roberts was the deciding vote in the ruling, which shocked most political and legal analysts, he took away the one means for the federal government to guarantee states' compliance: the ability to take away all Medicaid funding if states refuse to expand the health care program.
Predictably, Republican state governors like Florida's Rick Scott and Texas's Rick Perry have drawn their anti-Obama lines in the sand stating they would not expand Medicaid to those eligible uninsured, even though their states would receive millions of federal dollars to pay for it.
They also refused to set up state health care exchanges where consumers could shop and compare plans and rates to get the best coverage.
In Illinois, there isn't the same loud bellowing from the Democratic governor, however there is scrambling in Springfield by Republicans and insurance industry-backed Democrats to obstruct the health care law in favor of insurance companies' bottom line.
Jim Duffet, executive director of Illinois-based Campaign for Better Health Care, welcomed the high court's ruling and called on lawmakers to comply.
"It is time for the obstructionists in the Republican Party in Congress and in Springfield, and a handful of insurance industry backed Democrats in Springfield to stop their crusade against Obamacare," he said in an email statement.
Duffet called on Gov. Pat Quinn to sign an executive order mandating the insurance exchange. Duffet was part of the more than 100 health, education and labor groups and leaders who signed and sent a letter to Quinn asking him to issue such an executive order, Progress Illinois reports.
The governor has not ruled out taking such action. He also said Illinois plans to expand the Medicaid coverage - even after cutting it in the recent budget. Under the Affordable Care Act, the federal government pays for the first three years of Medicaid expansion and after that the federal share drops to 90 percent coverage.
Illinois has received $39 million in federal grants to study and start putting together an exchange. But Springfield lawmakers refused to pass a law requiring it last session, claiming they wanted to wait for the Supreme Court decision.
Dr. Aida Giachello, professor of preventive medicine at Northwestern and chair of CBHC's Latino health committee, said after the ruling, professionals and lawmakers can focus on providing health care.
"This is a good day for the United States. Now we can focus on health care and not sick care. Under Obamacare, 9 million Latinos will gain coverage," she said in a statement.
Highlights of the Affordable Care Act include:
- Children 18 and under with preexisting conditions get coverage. This will extend to adults in 2014.
- Insurance companies cannot drop you when you get sick.
- Young adults can stay on their parents' insurance plan until age 26.
Discrimination base on gender, which translated to women paying insurance companies up to 150 % more for coverage, is prohibited.
- Preventative care and screening such as mammograms and pap smears are free.
Small business owners get a tax credit to help provide coverage for their employees.
If your job does not provide insurance you will be able to buy into an insurance exchange and costs are based on income.
- Medicaid eligibility is expanded, as is funding for community health clinics.
- Seniors will receive better Medicare coverage and no copayments for preventivecare. The "donut hole" for prescription drugs is closed.
- Insurance companies must spend 80 percent of premiums on health care, not CEO bonuses or other "administrative" costs. Millions will receive a rebate from insurance companies' failure to do that.
Photo: Celebration of Obamacare, hosted by Rep. Nancy Pelosi. Office of Rep. Nancy Pelosi