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High stakes in the health care ruling

The Supreme Court is set to rule on the individual mandate, which requires almost everyone to buy health insurance. For some people, the decision could be life-changing.

Kai Ryssdal: We're down to 10 days or so left for the Supreme Court to clue the rest of us in on its thoughts about the health care law. Much of the oral arguments before the Court back in March was about the law's most controversial provision, the individual mandate that forces virtually everybody to buy health insurance.

With the ruling looming, we asked Marketplace's Nancy Marshall-Genzer for a refresher.


Nancy Marshall-Genzer: First, let’s meet Caty Poole. She’s 45, and uninsured. Works two part-time jobs. She tried to buy insurance not long ago, wnd was told, 'sure, we’ll sell you a policy. But we see you’ve been to a chiropractor. So we won’t cover any back problems you have.' Poole said no thanks.

Caty Poole: I would rather take the risk of not being insured and pay for care out of pocket than I would for paying for a policy that’s not going to give me the coverage that I would need.

The health care law says, starting in 2014, insurers won’t be able to discriminate against people like Caty Poole, who have pre-existing conditions. The individual mandate is designed to balance things out. People who aren’t sick yet help pay for people who are. The Obama administration says without the mandate the law won’t work. Poole says, without the mandate, she’ll remain uninsured. And hope she doesn’t have an accident.

Poole: Even just a simple cut on my finger, cooking at dinner at home, could be stitches in the emergency room.

Adrian Baumann is one of the people insurers would rely on to balance out Caty Poole. He’s 27, young and healthy. Just out of grad school. He says he would buy insurance if he had to. But he’d resent it.

Adrian Baumann: It’s more the tradeoff between paying for health insurance and having the ability to do other things. And by other things I don’t mean party, have nice clothes -- I mean pay off my debt.

But the mandate won’t apply to everyone. If you don’t make much money, you’re exempt.

And it’s not all about the mandate.  The Supreme Court could strike down the entire law. Some new rules already in effect would go away, including drug discounts for seniors who fall into the dreaded donut hole when they don’t get any government help to pay for medications.

Jean Somers is 72.  She says without the discount…

Jean Somers: It would either be don’t eat, and take your medicine, or take your medicine and don’t eat.

So, there you have it. Three generations of people, all holding their breath until the Supreme Court ruling, which could come as soon as tomorrow.

In Washington, I’m Nancy Marshall-Genzer for Marketplace.

About the author

Nancy Marshall-Genzer is a senior reporter for Marketplace based in Washington, D.C. covering daily news.

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