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Going on vacation is a great way to relax and get a break from your hectic lifestyle.  While a vacation can provide you with a break from your daily life, there are still a variety of problems that can arise. Knowing how to deal with these problems correctly can help you to have a great time on your trip regardless of the issues you face. One of the worst things that can happen during a vacation is getting sick. Instead of packing your things up and heading home, you need to stick it out and have a good time in spite of your sickness. Below are some of the things you can do to deal with getting sick while on vacation.

  1. Check Your Health Insurance before Going on Vacation

Before you leave for your vacation, you need to spend some time checking your health insurance policy. You have to make sure that the policy you have will cover the cost of treatment in another country or state. Usually, you will have no problem extending your coverage to another state, but traveling out of the country can pose some problems. The only way to find out what your insurance policy will cover is by calling the insurance company that handles the policy. They will be able to give you a breakdown of what your policy allows and can answer any questions you may have. By taking the time to call your insurance provider, you can avoid any surprises should you get sick while on a trip to another country.

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  1. See a Doctor and Start Taking Medicine Right Away

If you find yourself becoming sick while on vacation, getting to a doctor and starting the right medicine is essential. The faster you are able to start taking the right medicine, the less time you will have to deal with your ailments. Be sure to speak with the doctor about what pharmacies are in the area. If at all possible, you want to choose a pharmacy that can deliver your medicine to your hotel. A service like Kushly will be able to get you the medicine you need in a timely manner. By working with a delivery service, you can avoid getting lost in a new city when trying to find a pharmacy. Paying a bit extra for these services is a great idea due to the convenience it can provide you.

  1. Help To Protect Your Travel Companions

If you find yourself sick while on vacation, one of the main things you should worry about is keeping your travel companions safe. Doing things like removing your toothbrush from the sink or even avoiding touching their things can make a big difference when trying to keep others in your room from catching the ailment you have. Exercising this caution is especially important if you are traveling around with children. You should also encourage the people staying in the room with you to wash their hands frequently to remove any germs that may exist.

  1. Make Your Hotel Room Your Personal Recovery Ward

Another important thing you should do when getting sick while on vacation is turning your hotel room into a personal recovery ward. Most hotel rooms will have everything you need to tough it out until you feel better. Watching television or even getting on your computer is a great way to pass the time. Most of the hotels out there have WIFI and tons of channels for you to take advantage of. Realizing that your illness is only temporary is important. Getting down in the dumps about being sick isn’t going to help your situation, which is why keeping a positive outlook is important.

With some medicine and the right frame of mind, bouncing back from an illness while on vacation will be much easier. Waiting to get medical treatment for your ailment will only make things worse, so schedule an appointment with a doctor’s office in the area as soon as possible.

According to a congressional report published on June 26, some 22 million Americans could lose their health insurance over the next decade under a Senate bill to replace ObamaCare.

The non-partisan Congressional Budgetary Office (CBO) said the bill would reduce the budget deficit.

Similar legislation passed by the House was also said to leave millions uninsured. Some Republicans have voiced reservations about the plan.

However, the White House disputed the CBO’s figures.

Image source Wikimedia

Responding to the report, it said: “The CBO has consistently proven it cannot accurately predict how healthcare legislation will impact insurance coverage.”

House to Hold Vote on ObamaCare Repeal Bill

The report is a review of draft legislation unveiled by the Republican Party last week.

It is unlikely to be approved by Democrats, who see the proposals as cruel and unfair.

The CBO said that 15 million more people would be uninsured by 2018 under the proposed legislation than under current law, largely because the penalty for not having insurance would be eliminated.

President Donald Trump’s party is struggling to secure the 50 votes it needs to get its bill through the Senate when it comes to the floor.

The Senate bill would slash taxes for the wealthy offering less help for working families to buy medical insurance.

Republicans have rejected the notion that anyone will die as a result of their healthcare plan.

Around 14 million more people would lose health insurance coverage in 2018 under the new Republican healthcare plan, according to a budget analysis.

The Congressional Budget Office (CBO), a nonpartisan group of budget analysts and economists, released its assessment on the long-awaited Republican bill.

The CBO said the number of extra uninsured would jump to 24 million by 2026.

The bill would also reduce the federal deficits by $337 billion over the 10-year period, according to the CBO.

Those savings could help House Republicans sell the legislation to some conservatives who remain skeptical about costs.

President Donald Trump has backed the plan, which would replace the Affordable Care Act (ObamaCare), but the new legislation has faced a backlash from Democrats and even some Republicans.

Republicans have said the goal of the American Health Care Act is to lower costs and that coverage statistics are misleading due to the high out-of-pocket costs under President Barack Obama’s signature health law.

House Speaker Paul Ryan highlighted the CBO analysis’ conclusions on deficit reduction and decreased premiums.

He said: “I recognize and appreciate concerns about making sure people have access to coverage.

“[O]ur plan is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford.”

Health and Human Services Secretary Tom Price said the administration “strenuously disagreed” with the report’s findings on the number of people who would lose coverage.

He said after the assessment was released: “Right now, current law, we’ve got individuals who have health coverage but no healthcare.”

Tom Price contended the new plan would cover more individuals at a lower cost.

Democrats jumped on the figures in the new assessment.

California Representative Adam Schiff tweeted that the numbers in it were “appalling” while Virginia Representative Don Beyer called it a “disaster”.

He tweeted: “Now we know why @Speaker Ryan rushed to pass his repeal bill; CBO says it kicks 24 million off their healthcare in next 10 years. Appalling.”

The CBO, along with the Joint Committee on Taxation, also found that five million fewer people would be covered under Medicaid, which covers low-income people, by 2018.

An estimated 14 million fewer people would enroll in the Medicaid program by 2026.

The report found that by 2026, an estimated 52 million people would be uninsured, compared with the 28 million who would not be covered that year under the current law.

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Today, we’re going to talk about a crucial part of your personal finances; insurance. More specifically, we’re looking at four types of insurance you need to have:

car-insurance

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Car Insurance

This is perhaps the most well-known and talked about insurance. If you ask someone to name an insurance type, the majority will say car insurance. But, what is it and why do you need it? Basically, it insures your car against different kinds of damage. This means that if you get into an accident, your insurance provider will pay for any repairs that are needed. Obviously, this can save you a lot of money, and I mean a lot. If your car is severely damaged, you can get it fixed through your provider and save tonnes of money. Without insurance, you might have had to fork out lots of money on a new car. Plus, it’s illegal to drive a motor vehicle without it being insured. So, you have to make sure you’ve got it for your car. There are tonnes of providers out there that will give you quotes depending on a few factors. Age, gender, driving experience, and the car you drive can all have a bearing.

Home Insurance

Another type of insurance that you must have is all to do with your home. Yes, home insurance is essential for anyone that owns property. With it, you’ll get the option to protect two aspects of your house. You can get accidental damage cover and contents cover. The first of which will protect you if your home gets damaged for whatever reason. Maybe a storm damaged your roof, or someone broke your window. Either way, if your home insurance covers this, you’ll have the repairs paid for. Contents cover will protect you if your house ever gets burgled. If someone steals items from your house, you’ll be covered. Similarly, home insurances will protect your possessions if they get damaged in floods, etc. Some companies will give you replacement items free of charge. If you own a property, then you can’t forget about home insurance, trust me.

Life Insurance

Life insurance is something that no one likes to think about, but it’s very important. You see, we get life insurance to cover our family in case we die. As you can tell, this is a very sensitive topic, which is why people don’t like thinking about it. No one wants to talk about death, but sometimes you have to. With life insurance, your family will get money paid to them, if you pass away. This means they’re going to be financially stable when you’re gone. You may be the primary money maker in your house, so if you’re not there to earn money, they could be in trouble. Thankfully, life insurance ensures that your family finances are not ruined by your death. Types of life insurance can vary, some come with critical illness cover, others have certain requirements. Although you don’t like to think about it, death is inevitable. It makes sense to give your family some financial gain when you pass away.

Health insurance

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Health Insurance

One of the most important things in life is your health. If you aren’t healthy, you need to get treatment and see a doctor. Doctors can help you get better and back to feeling your best. When you have health insurance, seeing medical professions is a lot easier. In fact, some institutions only accept people that have insurance. What health insurance does is protect your health and wellbeing. It can cover the cost of doctors appointments, operations, physical therapy, etc. Without it, it’s very hard to find reliable, high level, medical care. Sure, there are some public options for people without insurance. However, the waiting times for appointments are insane, let alone the wait for surgeries. Without health insurance, you could be waiting for surgery for up to two years! But, if you have it, you can get the surgery covered by your insurer and make sure you’re seen to as soon as possible. It’s highly recommended for everyone, particularly those with a family.

Insurance is a very important part of your financial life. It can protect you from so many things and ensure you aren’t paying loads of money for different stuff. Imagine if you had none of the insurance above. Think about how much money you’d have to pay to cover things like car breakdowns, medical bills, and so on. Getting insurance can give you a more stable life, and set your family up for a comfortable future.

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If you’ve ever had a prescription filled in the United States, you’re aware that American drug prices can be ridiculously high. But some drugs are pricier than others — and health insurance providers are fighting back.

The recently released prescription drug Solvadi (sofosbuvir) is a case in point. Solvadi is the only cure for hepatitis C, a liver infection that can lead to cirrhosis, liver cancer, liver failure and ultimately death. You’d think this drug would be a godsend for the many patients struggling with hepatitis C — until you got a look at the price.

pills-on-hundred-dollar-bills-health-care-insurance-money-prescription-drug-pricesSolvadi costs a staggering $1,000 a pill, or $84,000 for a full, 12-week course of treatment. Other specialty drugs, like those used to treat rheumatoid arthritis, cancer and multiple sclerosis can cost patients an average of $10,000 a month. Even drugs for more common conditions can be prohibitively expensive for most people, which is why many Americans turn to online pharmacies like Medicines Mexico to cut their prescription drug costs.

Health insurance providers say drug prices that high simply can’t be borne. Many insurers are now refusing to cover the costs of expensive drugs at all, at least in cases where the drug’s perceived benefit doesn’t justify its price, or there are other drugs available that do the same thing for less money. Patients will be forced to use similar drugs with lower price tags.

Prescription Drug Access Is a Problem for Many Americans

Prescription drug sales topped out at $326 billion in the 12 months prior to September 2013, and Americans’ prescription drug spending is expected to grow by three to five percent by the end of 2014. The high price of prescription drugs is to blame, and physicians around the nation are aware that, for most people, affording prescription drugs is difficult, especially when it comes to obtaining some of the most expensive treatments.

Jerry Avorn, a Harvard Medical School professor and chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, told CNBC, “Access really is a problem for a lot of patients in relation to these very costly medicines. We sometimes think, ‘Well, people have insurance, and under Obamacare there’s a lot more coverage,’ but what that doesn’t take into account is that very often there is a very big co-payment that the patient has to come up with that is often many, many hundreds or thousands of dollars.”

In 2012, Memorial Sloan-Kettering Cancer Center chose to stop prescribing the costly cancer medication Zaltrap (ziv-aflibercept) on the grounds that the drug didn’t provide any additional benefit over older drugs, despite its substantially higher cost. In response, the drug’s French manufacturer, Sanofi, cut the price of Zaltrap in half.

Insurers Forcing Drug Price Negotiations

While the U.S. Centers for Medicare and Medicaid services are prohibited by law from attempting to negotiate lower drug prices, health insurance providers are not. With rising health care prices affecting everyone, insurance providers are now giving pharmaceutical manufacturers a choice. Either drug manufacturers can slash the prices of their most expensive drugs, or insurers will remove those drugs from their formularies. A drug not listed in an insurance provider’s formulary won’t be covered under any plans — patients who want it will have to pay full list price out of their pockets.

Of course, health insurance providers aren’t going to dump drugs just because they’re expensive. If there’s no equivalent drug available yet — such as in the case of Solvadi — insurers will likely still cover it regardless of cost. But patients are already being asked to switch to less expensive equivalents of the medications they need — CVS Caremark dumped around 30 expensive drugs from its formulary in 2012 and 70 more this year; next year’s formulary will exclude 200 drugs. Express Scripts dumped 48 drugs and medical products this year. A new Catamaran formulary is 54 drugs lighter this year. Some of the drugs dumped include popular prescriptions like Advair (fluticasone/salmeterol) and Victoza (liraglutide).

So far, American drug manufacturers haven’t responded by lowering the prices they charge insurance companies. Nor will the strategy affect list prices, the prices paid by patients who must buy their drugs out of pocket, without help from an insurance provider. List prices will remain the same. Instead, insurers hope that by dumping costly drugs or forcing manufacturers to bargain, they can keep premium costs low.

Drug prices are astronomical, especially for some specialty drugs used to treat cancer, hepatitis C, rheumatoid arthritis and multiple sclerosis. Insurance providers, in a bid to keep premiums manageable, are dumping expensive drugs by the dozens. Unless drug manufacturers decide to start bargaining with insurers, patients will find their prescription drug options dwindling by the year.

The US Court of Appeals for the District of Columbia has thrown out a federal regulation implementing key subsidies of President Barack Obama’s signature healthcare law, ObamaCare.

It means that participants in health exchanges run by the federal government in 34 states are not eligible for help.

The ruling deals a setback to ObamaCare, jeopardizing health insurance for four million low and middle-income people.

The White House said it is confident in its legal position on subsidies.

The ObamaCare has been under siege by opponents since it was passed in 2010.

A three-judge panel found in favor of plaintiffs who sued over tax credits for people buying health insurance.

The US Court of Appeals for the District of Columbia has thrown out a federal regulation implementing key subsidies of ObamaCare

The US Court of Appeals for the District of Columbia has thrown out a federal regulation implementing key subsidies of ObamaCare

“Our ruling will likely have significant consequences both for millions of individuals receiving tax credits through federal Exchanges and for health insurance markets more broadly,” Senior Circuit Judge Raymond Randolph in his majority opinion.

The US Court of Appeals for the District of Columbia ruled on Halbig v Burwell on Tuesday, one of four lawsuits currently challenging the legality of Internal Revenue Service (IRS)-funded subsidies under the Patient Protection and Affordable Care Act.

The court – considered the second highest in the nation behind the US Supreme Court – returned the case to a lower court with instructions to rule in favor to plaintiffs who had fought against the subsidies being offered in 36 states.

The IRS is said to have dispensed billions of dollars in taxpayer subsidies through federal healthcare exchanges, or marketplaces.

Plaintiffs in the lawsuit argued they were injured by the IRS actions because it triggered additional taxes for employers.

The subsidies, or tax credits, have been made available to Americans with annual incomes up to 400% the federal poverty level.

That works out to $94,000 for a family of four.

In a dissenting opinion, Judge Harry Edwards calling the lawsuit a “not-so-veiled attempt to gut” the healthcare law, and “portends disastrous consequences”.

The US Appeals Court’s ruling may impact on more than four million Americans who are currently eligible for subsidies to offset their healthcare costs.

Should this mean large numbers of people be ineligible for health insurance, it would result in higher overall premiums for non-subsidized members.

The ruling is the latest blow for the embattled healthcare law, which last month saw the US Supreme Court overturn a crucial portion regarding contraception coverage.

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Hillary Clinton criticized the Supreme Court for ruling that an employer can refuse to provide women with contraception on religious grounds.

Hillary Clinton said when asked about the court’s 5-4 decision during the Aspen Ideas Festival in Colorado: “Well I obviously disagree.”

“I disagree with the reasoning as well as the conclusion. Just think about this for a minute.”

Hillary Clinton criticized the Supreme Court for ruling that an employer can refuse to provide women with contraception on religious grounds

Hillary Clinton criticized the Supreme Court for ruling that an employer can refuse to provide women with contraception on religious grounds

The former secretary of state noted that the ruling could be broadened out to include other medical procedures that other religions object to.

“So does that mean if you have need for a blood transfusion your insurance doesn’t have to cover it?” she asked.

“So I mean this is a really bad slippery slope.”

Hillary Clinton also guessed that some businesses would lie about religion just to avoid higher costs.

“I think there should be a real outcry against this kind of decision,” she said.

“Many more companies will claim religious beliefs and some will be sincere, but others maybe not. And we’re going to see this one insurable service cut out from many, many women.”

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Millions of people in the US receive health insurance cover for the first time as ObamaCare healthcare reforms – Affordable Act Care – come into effect as of 1st of January 2014.

President Barack Obama’s reforms are part of his aim to ensure affordable healthcare is available to everyone.

But the policy is controversial and the roll-out of the new system has been beset with problems.

Some religious-affiliated groups won a last-minute reprieve from being forced to provide birth control cover.

Supreme Court Justice Sonia Sotomayor temporally blocked the government from forcing such groups to offer health insurance that would include contraception.

Sonia Sotomayor acted at the request of a group of Catholic nuns in Colorado, the Little Sisters of the Poor, who had earlier lost their request for a preliminary injunction at an appeals court in Denver.

They had argued that the ruling conflicted with the Catholic Church’s stance against the use of contraceptives.

Millions of Americans will receive health insurance cover for the first time as ObamaCare comes into effect

Millions of Americans will receive health insurance cover for the first time as ObamaCare comes into effect

Under the Affordable Care Act, it is now compulsory for people to have health cover – either provided for by their employer or by buying one of the private health plans now on offer.

Those who cannot afford it will get help, but those without any insurance will be fined.

As of 1st of January 2014, health insurance companies are also no longer able to deny coverage to people with pre-existing conditions.

More than 2.1 million people have enrolled so far for private health plans – short of the government’s original target.

But the phased roll-out of the new law has suffered a number of difficulties.

The Healthcare.gov website offering the new health plans was plagued with technical glitches when it was launched in October. There were long sign-in wait times, log-in difficulties, insurance account creation problems, slow page loads and outages.

Insurance companies have also announced the cancellation of millions of policies, saying they did not meet the law’s minimum requirements.

This came despite President Barack Obama’s promise that people would not be forced to move from plans they were happy with.

Barack Obama’s approval ratings fell in the wake of the problems, but the White House says things have been fixed.

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The US government has offered help to people who missed the December 24 deadline to enroll for the ObamaCare.

The government said anyone who failed to finish their application through a dedicated website – HealthCare.gov – could still obtain a policy for the new year.

On Monday, it extended the original deadline by a day amid high demand and technical issues.

HealthCare.gov has been plagued by glitches since its October 1st rollout.

The problems with President Barack Obama’s signature bill have hit his popularity ratings hard.

The website was set up under a 2010 healthcare law that seeks to cover millions of Americans who do not have health insurance.

The US government has offered help to people who missed the December 24 deadline to enroll for the ObamaCare

The US government has offered help to people who missed the December 24 deadline to enroll for the ObamaCare

“Sometimes despite your best efforts, you might have run into delays caused by heavy traffic to HealthCare.gov, maintenance periods, or other issues with our systems that prevented you from finishing the process on time,” a message on the federal marketplace website said just hours before the Tuesday midnight deadline.

“If this happened to you, don’t worry – we still may be able to help you get covered as soon as 1 January.”

The website also provided helpline contact numbers and told applicants to “tell our customer service representative that you’ve been trying to enroll and explain why you couldn’t finish by the deadline.

“They can tell you what you can do to finish your enrolment and still get covered for 2014.”

Two states have extended the deadline for coverage in the new year even further, to December 27th in Maryland and December 31st in Minnesota.

While the website has been upgraded over the course of the past two months, it has still experienced downtime in the past few weeks.

Americans may still enroll in private insurance plans through the website after December 24th, but they will not be guaranteed coverage at the start of the new year.

A more important deadline for the Obama administration is March 31st 2014, when enrolment in the programme ends for the year.

Those who do not have coverage through their employer, government-run health programmes or through the federal or state-run websites by then will have to pay a tax penalty.

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President Barack Obama has signed up for health insurance coverage under ObamaCare.

A White House representative said Monday that the president enrolled in a health plan through the Washington, D.C. insurance marketplace over the weekend.

Barack Obama chose one of the cheapest plan – bronze plan – which covers 60% of medical costs.

Barack Obama chose bronze plan which covers 60 percent of medical costs

Barack Obama chose bronze plan which covers 60 percent of medical costs

“The act of the President signing up for insurance coverage through the DC exchange is symbolic since the President’s health care will continue to be provided by the military,” the aide said.

Barack Obama will pay premiums for the plan, though, the aide said. The insurance would cover only the president, not his wife or children, and the premium will be less than $400 per month.

All presidents and their immediate families get coverage through the military. As Commander-in-Chief, any president has a personal physician and he and his family get full care at the White House Medical Unit and the National Naval Medical Center in Bethesda, Maryland.

President Barack Obama is planning to rally support for ObamaCare and stem a wave of bad publicity over his flagship domestic achievement.

The president was joined at the White House by Americans who said they had benefited from the Affordable Care Act.

The new healthcare.gov website, which sells medical insurance, is now working at acceptable levels after its disastrous launch, says the administration.

The act aims to provide health coverage to some 15% of US citizens who lack it.

Barack Obama sought to remind Americans that under his health programme, insurers can no longer deny coverage to those with pre-existing conditions, and young people can now stay on their parents’ coverage until age 26.

He discussed the intensive efforts to repair the healthcare.gov website, which has been a flop since it went online on October 1st.

“Today the website is working well for the vast majority of users,” Barack Obama said.

President Barack Obama is planning to rally support for ObamaCare

President Barack Obama is planning to rally support for ObamaCare

“More problems may pop up, as they always do when you’re launching something new. And when they do we’ll fix those, too.”

The White House is also due to hold a youth summit on Wednesday, in the latest attempt to promote the law among the young and healthy, a demographic crucial to the strategy of reducing overall healthcare costs.

It is part of a multi-pronged effort by the administration to counter the Republican argument that the act known on both sides of the political divide as ObamaCare is “a train wreck”.

The law’s problems have sent Barack Obama’s job approval ratings plunging and threaten to damage fellow Democrats in next year’s congressional elections.

Elsewhere in Washington DC on Tuesday, the White House’s chief of staff told a public policy forum that more than one million new visitors had logged on to healthcare.gov a day earlier.

Denis McDonough said the website’s new queuing system, used in times of high traffic, worked “pretty well”.

“No matter what, we’re going to see this thing through,” he said.

He did not provide updated figures for how many people had signed up for insurance plans.

The administration aims to enroll 7 million people in insurance plans before the end of March, when all Americans are required to have coverage or pay a fine.

But problems reportedly persist. Insurers say they are receiving enrolment forms that have errors or are duplicated, while others go missing altogether.

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Presidents Barack Obama and Bill Clinton have joined forces to promote Obama’s healthcare initiative, known as Obamacare, just days before one of its major provisions takes effect.

In New York, they discussed the law’s progress and denounced Republican efforts to stymie its implementation.

Beginning on October 1st, Americans who lack health insurance will be able to buy policies in online market places.

Barack Obama said opponents were trying to “scare” people from signing up.

Even as conservative groups have undertaken a broad effort to undermine the law by persuading people to ignore it, Barack Obama said he was confident Americans would come to see its advantages.

“When people look and see that they can get high-quality, affordable healthcare for less than their cell phone bill, they’re going to sign up,” Barack Obama said.

The discussion, billed as an interview by Bill Clinton of Barack Obama took place on the sidelines of the UN General Assembly in New York.

It was part of the Clinton Global Initiative, a conference featuring Bill Clinton that he has held regularly since leaving the White House in 2001.

Presidents Barack Obama and Bill Clinton have joined forces to promote Obamacare

Presidents Barack Obama and Bill Clinton have joined forces to promote Obamacare

The Patient Protection and Affordable Care Act, which Barack Obama’s Democratic Party passed in 2010 in the face of unified Republican opposition, has been the centrepiece of Obama’s domestic policy agenda.

Its provisions include a requirement, which takes effect in January, that individuals who do not have health insurance provided by their employers purchase it on the open market.

On October 1st, online health insurance marketplaces run by the US federal government or by the states will begin accepting customers.

Opposition to the law, which is known to both sides of the debate as Obamacare, has become one of the central tenets of Republican and conservative politics, analysts say.

The House of Representatives, which is controlled by the Republican Party, has held dozens of votes on bills to repeal the law or strip it of funding. The bills have gone nowhere in the Democratic-controlled Senate.

The law has become a central point in the ongoing budget battle, with some Republicans pushing to shut down the operation of the US government by not passing a new budget if the Democrats refuse to defund the law.

On Friday, the House passed a bill that would prevent a government shutdown – but would strip the healthcare law of its funding. And on Tuesday, Republican Senator Ted Cruz of Texas undertook a marathon speech on the floor of the Senate to denounce the law and demand the government block its implementation.

“Those who have opposed the idea of universal healthcare in the first place and have fought this thing tooth and nail through Congress and through the courts and so forth have been trying to scare and discourage people from getting a good deal,” Barack Obama said.

On Monday, Bill Clinton asked Barack Obama why he had decided to tackle healthcare reform early in his first term, even as the economy was mired in one of the worst downturns since the Great Depression.

Barack Obama said healthcare was a “massive” part of the American economy, and noted the US was the only advanced industrialized nation that permitted “large numbers of its people to languish without health insurance”.

President Barack Obama also accused congressional Republicans of using the “pretty straightforward” issue as political capital as the government hurdles toward a shutdown on October 1st, when the law funding its operation expires.

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Barack Obama’s wide-ranging healthcare reform bill, which is seen as a key achievement of his presidency, is facing its moment of judgement in the US Supreme Court.

The law, dubbed ObamaCare, passed in 2010, requires all Americans to obtain health insurance or face a penalty fine.

But conservative opponents of the president say that “mandate” is illegal under the terms of the US constitution.

The justices are expected to rule on Thursday, and could cut the mandate or strike down the whole law.

The debate over healthcare is a fiercely polarizing issue in the US, and a verdict either way is expected to have a major impact on the race for the White House.

Barack Obama and Republican Mitt Romney, a former Massachusetts governor, are just five months away from the presidential election.

The president maintains a slender lead in some polls, but is facing a stiff challenge from Mitt Romney and conservative opponents, amid a rocky economic outlook.

ObamaCare, passed in 2010, requires all Americans to obtain health insurance or face a penalty fine

ObamaCare, passed in 2010, requires all Americans to obtain health insurance or face a penalty fine

Mitt Romney told a rally near Washington DC on Wednesday that if the Supreme Court did not quash the law he would “repeal and replace” the bill if he won the White House.

The bitter debate over the legislation has touched such partisan issues as state and individual rights, federal deficits, end-of-life care, and abortion and contraception funding.

The nine-member Supreme Court has several options.

It could decide that it is too early to rule on the case, as many of the law’s provisions – including the mandate to buy health insurance – do not come into force until 2014.

It could also dismiss the challenge to the mandate on a technicality, ruling that the penalty constitutes a tax lawfully imposed by Congress. Few observers expect the court to choose this option.

The meat of the case concerns the challenge to the individual mandate, which the justices could decide oversteps Congress’ right to regulate interstate commerce.

Analysts say that questioning from several conservative justices during oral arguments at the court in March revealed a deep level skepticism on the bench.

The court could decide to strike down the mandate and send the bill back to Congress to find a way to make the rest of it work. It could also overturn the entire law, ruling that the need to buy health insurance is integral to the legislation.

The Supreme Court is composed of nine justices, five seen as conservatives and four as liberals. It has delivered several divisive wafer-thin majority rulings in recent years, prompting criticism from liberals.

A 5-4 ruling in 2010 known as Citizens United changed campaign finance laws in the US to allow unrestricted fund-raising by independent groups not directly affiliated with candidates.

A recent study by the Pew Research Center found public approval of the court at its lowest level since records began in 1987.

The healthcare law – officially known as the Patient Protection and Affordable Care Act, but commonly dubbed ObamaCare by opponents – was passed in 2009 without a single Republican vote in Congress, and signed into law by President Obama in June 2010.

Polls suggest many Americans would be pleased to see the law overturned.

However, individual elements of the bill are popular, and some people are opposed because they do not think it goes far enough.

The bill has already enabled millions of Americans aged under 26 to obtain health insurance by staying on their parents’ coverage for longer than previously allowed.

Patients with pre-existing medical conditions have also been able to obtain health insurance since the passage of the law.