Affordable Care Act

It will be up to state officials and Congress to help consumers who can't afford health insurance if the Supreme Court strikes down health law subsidies for millions of Americans, Health and Human Services Secretary Sylvia Burwell.

"The critical decisions will sit with the Congress and states and governors to determine if those subsidies are available," Burwell told the House Ways and Means Committee on Wednesday.

Diabetes is something nurse practitioner Martha Brinsko helps a lot of patients manage at the Charlotte Community Health Clinic in North Carolina.

"Most mornings when you check your sugar, what would you say kind of the average is?" Brinsko asks Diana Coble.

Coble hesitates before explaining she ran out of what she needs to check it, and she didn't have the gas money to get back here sooner. Brinsko says Coble can get what she needs at the clinic.

The politics of the Affordable Care Act in the state of Louisiana aren't subtle: The law isn't popular.

The state was part of the lawsuit to strike down Obamacare in 2012; it didn't expand Medicaid and has no plans to. Louisiana also didn't set up its own marketplace to sell health insurance.

The Affordable Care Act requires all Americans to get health insurance or pay a penalty. To help coax people to buy a health plan, the federal government now subsidizes premiums for millions of Americans.

The old saying goes, "Nothing is certain except death and taxes." But the Affordable Care Act has added a new wrinkle.

For many policyholders, the ACA has introduced a good deal of uncertainty about their tax bills. That has led to surprise refunds for some and higher-than-expected tax payments for others.

Johnny Reynolds knew that something was wrong as far back as 2003. That's when he first started experiencing extreme fatigue.

"It was like waking up every morning and just putting a person over my shoulders and walking around with them all day long," says Reynolds, 54, who lived in Ohio at the time.

In addition, Reynolds was constantly thirsty and drank so much water that he would urinate 20 or 30 times per day. "And overnight I would probably get up at least eight or nine times a night," he says.

The Supreme Court heard arguments Wednesday in a case that could end Obamacare subsidies for policyholders in a majority of states, including Texas, Florida, Illinois, Pennsylvania and Ohio. If the court sides with the plaintiffs, it would mean millions of people could no longer afford health insurance.

Anne Roberson walks a quarter-mile down the road each day to her mailbox in the farming town of Exeter, deep in California's Central Valley. Her daily walk and housekeeping chores are her only exercise, and her weight has remained stubbornly over 200 pounds for some time now. Roberson is 68 years old, and she says it gets harder to lose weight as you get older: "You get to a certain point in your life and you say, 'What's the use?' "

The House voted 239-186 today to repeal the Affordable Care Act, the latest effort by the Republican-controlled chamber to scrap the law.

The measure also would direct panels to come up with a replacement for the healthcare law — though it doesn't provide a timeline on any new legislation or what provisions it may contain.

For two decades Atlanta restaurant owner Jim Dunn offered a group health plan to his managers and helped pay for it. That ended Dec. 1, after the Affordable Care Act made him an offer he couldn't refuse.

Subsidies under the health law for workers to buy their own coverage combined with years of rising costs in the company plan made dropping the plan an obvious — though not easy — choice.

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