White House: If Supreme Court Strikes Down Health Care Law, "Pretty Cataclysmic Impact"

At a White House Townhall on Women's Health, Health & Human Services Secretary Kathleen Sebelius said if the Supreme Court overrules the health care law, a host of provisions, including making it illegal to discriminate based on pre-existing conditions, could "cease to be the law of the land."

If the White House is worried about how the U.S. Supreme Court might rule on its health care law, with a decision expected as early as next week, it certainly isn't showing it. "We still remain confident and optimistic that this change in the law (declaring that all Americans must have health insurance by 2014) was well within the purview of the Congress," said Kathleen Sebelius, Health & Human Services Secretary at a special townhall on women's health livestreamed on WhiteHouse.gov and on iVillage.

iVillage was lucky to be part of a two-person media panel and ask questions from you about the law, called the Affordable Care Act. Too few Americans seem to really know what the law does -- how it allows young men and women to stay on their parents' plans until the age of 26 and how it makes it illegal for insurance companies to deny coverage to kids with pre-existing conditions, to name just a few of its provisions. Kids like this little boy Jax who was born with his heart on the wrong side of his body.  He was at the townhall cooing (quietly!) for 90 minutes in the arms of his proud mom, Robyn.

We'll get to the fabulous questions, namely from our iVoices on iVillage, our real mom and dad contributors, but first to those newsy comments by the secretary.

"We'll be ready for court contingencies," said Sebelius. "What we're doing right now frankly is just working as hard as we possibly can to get ready for 2014," which is when nationwide insurance exchanges will be created where Americans can shop for health insurance coverage at competitive rates.  "We think that the best preparation is to anticipate that the law is fully constitutional and that people are eager to be eligible for these new marketplaces," she said.

Asked what can be "undone" by the highest court and what can't be undone, the secretary said a few of the plaintiffs have asked that the entire law be struck down and declared unconstitional. If that happened, she added, "Much of what we described here today would cease to exist."  In addition to the provisions helping kids in their 20's and kids with pre-existing conditions, the current law also creates pre-existing pools, which currently give 60,000 people with pre-existing conditions coverage they could not get anywhere else.  The law will also make it illegal, beginning in 2014, for anyone, adults included, to be refused coverage because of a pre-existing condition.

"It has some pretty cataclymsic impact along the way because really we've had two years of implementation," said the secretary, listing many of the benefits Americans now have as part of the new law. "Those would all cease to be the law of the land."

In my role, I asked questions from you of the panel, which also included Cecilia Munoz, Director of the White House Domestic Policy Council. I had so many great questions and so little time -- but in the end, I was able to ask a few.

The questions were from Beth Engelman, one of our iVoices on iVillage, and a co-founder of Mommyonashoestring.com, and Sharon Rowley, also of iVoices and creator of the blog, Momof6.com. Check out what they asked -- and what the secretary and others had to say!

Beth: How is the new health insurance bill going to affect my family's premiums -- will they go up?

Judy Waxman, National Women's Law Center: "There are provisions in the law that will make insurance companies more accountable and more transparent in the premiums that they charge. It's kind of a little known part, I think, but I would say it is already having an effect. Our own insurance at my organization in the past has gone up 10 percent a year and this year actually went down. (Audience claps)... It is because the companies now have to limit how much they can use of the premium for profit and for administrative costs and they have to be transparent about it. And that is a really an important step."

Beth: How will the health insurance bill help promote preventive care for children?

Secretary Sebelius: "It starts with it is now illegal for companies to deny coverage to children, that was not the case in the past... And then there is a directive in the bill that, in addition to looking at recommended preventive services for women, we also look to listing the preventive services for children and those become automatically updated and part of what is kind of an essential benefits package for an insurance company. You can be confident that as a parent, if you buy health insurance, your child will be covered and the preventive services from childhood vaccines to recommended treatments will not only be included but updated on a regular basis. As the science changes, as the science improves, that is automatically added to that benefit package."

Sharon: With the economy being so tough, and people losing their jobs, one of the toughest things they have to face right after the job loss is how to deal with maintaining medical insurance. Often the only option available is to take the coverage covered by Cobra...but the costs for Cobra are astronomical and sometimes just not possible for the family who just lost their income. What other options are available for people in this situation?

Secretary Sebelius: "It is a very tough situation.  Cobra coverage, when you are paying 100 percent of what your employer coverage is, is not affordable for lots of families. So a couple of things, the children, because of the family income level changing dramatically, may qualify for programs they didn't qualify for with a fully insured family. So that would be one thing to check out, whether they qualify for Medicaid or the Children's Health Insurance program, which is based on income levels...If one of the parents has a pre-existing health condition or the child has a pre-existing health condition, there are the pre-existing health condition pools, which are also in place to try to fill gaps in the marketplace. And the site HealthCare.gov could give them a snapshot of what's in the market at what price... And then, though in 2014, there will be a series of options that may not be available right now: expanded Medicaid coverage for lower income and for the first time...around the country, regardless of where you live, you will qualify for Medicaid at a standard rate so that is an option. And then tax credits available for the next group of income up to 400 percent of the poverty level in the new health insurance exchanges. So there are some options now and many more on their way. But the family might be able to find coverage for the kids and different coverage for the adults that is more affordable than ongoing Cobra coverage.

Kelly Wallace is Chief Correspondent of iVillage.  Follow Kelly on Twitter (@kellywallacetv).

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