Health care law's future still in question

WASHINGTON -- One year after President Barack Obama signed his historic health care overhaul, the law is taking root in the land. Whether it bears lasting fruit is still in question.

The legislation established health insurance as a right and a responsibility. Thousands of families, businesses and seniors have benefited from its early provisions.

But worries about affordability and complexity point to problems ahead. And that's assuming it withstands a make-or-break challenge to its constitutionality that the Supreme Court is expected to decide.

Public divisions over the law are still so sharp that Americans can't even agree what to call it. Supporters call it the Affordable Care Act, a shorter form of its unwieldy official title. It's also known as "Obamacare," the epithet used by Republicans seeking its demise.

While Obama returns from Latin America on the signing anniversary Wednesday, administration officials will fan out across the country. Community commemorations started Monday, underscoring that the health care battle has moved to the states. Even states suing to nullify the law's requirement that most Americans carry health insurance are proceeding with at least some of the building blocks.

Polls show that about one in eight people believe they have been personally helped already, well before the provision kicks in in 2014 to cover millions of uninsured.

No group is more sensitive to medical costs than senior citizens, whose votes are also critical to Democrats' chances in the 2012 presidential election. So far, alarms that Medicare cuts would compromise their care have not been borne out. But Democratic lawmakers engineered the cuts to take effect gradually, while new Medicare benefits are being provided now.

Topping the list this year is a 50 percent price cut on brand-name prescriptions for Medicare recipients who fall into the coverage gap called the "doughnut hole." Daniel Wisniewski, a retired truck driver from Staten Island, N.Y., reckons that will reduce the price of one of his heart drugs from $234.99 a month to around $117.

"I'm not much on politics, but I feel that that's got to help me," said Wisniewski, 69. "I worked and paid into Social Security for 55 years. When I was a kid I used to wash dishes in a bakery after school."

Republicans say such gains will be temporary. For families, "any marginal benefits from this law are far outweighed by the heavy-handed intervention in their health care by Washington bureaucrats," said Sen. Orrin Hatch, R-Utah.

Affordability is the main worry for critics. A recent poll by the nonpartisan Kaiser Family Foundation found that one in five Americans said they had been negatively affected by the law, and about half of those cited costs. Some blamed the law for this year's premium hikes, although many experts say the impact was marginal.

"If they have a bad experience in the marketplace, it's very possible they're going to attribute that to the law," said Mollyann Brodie, Kaiser polling director. "It certainly presents a challenge for the proponents."