O-ba-ma-care — those four syllables form a fighting word during this presidential campaign.
Some 42 percent of Kentuckians say the future of the Affordable Care Act (aka Obamacare) is one of their top two issues in the presidential election, according to a poll by the non-profit Foundation for a Healthy Kentucky. Of those polled, 45 percent think Republican Mitt Romney will do a better job with health care, compared to 40 percent who favor health-care reform architect Barack Obama.
"Kentuckians remain very concerned about health care and health insurance," said Susan Zepeda, chief executive officer for a Foundation for a Healthy Kentucky.
That concern stretches from the family room to the board room. Mark Turner, senior vice president of communications, said a Commerce Lexington poll this summer showed "a great deal of uncertainty surrounding the law." He said "a very large majority" were unsure of the effect or expected it to have a negative effect.
Phil Greer, owner of Greer Companies in Lexington, is sure.
"It's going to be a catastrophe," he said.
Greer has 6,000 employees at 30 restaurants, but he still sees his Lexington-based company as a family business. And for Greer and his son, Lee, Obamacare is a looming disaster overall, but as business owners they are particularly concerned about a government mandate that businesses offer employees insurance or pay a penalty.
The Greers offer health insurance to full-time employees, but father and son worry the cost will rise as more employees sign on to meet the requirement of an individual mandate. Lee Greer said costs of individual insurance plans will inflate because Obamacare requires that insurance companies match the minimum offerings of state-sponsored plans.
Beyond that, he said, the increase in health care will eat deeply into the company's profits. But, he said, employees in companies like his that already operate with a slim profit margin will suffer the most as they find their hours reduced to cover the increased cost of insurance.
Ultimately, he said, Obama care will raise the cost of everyday living, further hurting those at the bottom of the wage scale. Even the Greers' Cheddar's restaurants, which target the middle class with good food at low prices, will have to raise prices. "I'm either going to have to close my doors or raise my prices," Phil Greer said.
According to a survey by the Kaiser Family Foundation, 98 percent of businesses nationally with more than 200 employees offer health insurance, compared to 50 percent of businesses with three to nine workers and 73 percent of firms with 10 to 24 employees.
But Dave Sevigny, a self-described "fan of Obama care," doesn't understand the employer angst surrounding health care reform. Sevigny, owner of DMD Data Systems Inc. in Frankfort, began offering health insurance to his 15 employees last year. He said, in part, it seemed like the right thing to do. Plus, he said, most of his employees were paying for health insurance independently, so as a group he thought they might get a better deal.
Sevigny said in the competitive world of high tech, offering insurance is a plus when recruiting. "There were people that we wanted to attract that would get hung on their health care."
But, he said, it has taken a lot of research to find the right coverage, and "it's not the easiest thing for small business."
But, he said, he supports health care reform as "a social justice issue."
The employee mandate is one of the major points of division in the campaign.
Romney has said repeatedly that he'd repeal health care reform if elected.
Glen Mays, a professor in the University of Kentucky College of Public Health, said there is no doubt that health care under a president Romney would be very different than what is now in play. But, he said, elimination of a bill as far-reaching and complicated as the Affordable Care Act, especially when key provisions already are in place, would be a challenge.
"It would be very difficult, legally and politically, to repeal the entire package of legislation," he said.
Romney would attempt to allow states to opt out of the federal health law and encourage Congress to repeal it.
Obama and Romney have even found some common ground on health care, Mays said.
Romney, who supported health care reform as governor of Massachusetts, has signaled support for several popular parts of Obamacare.
For example, Romney has said he would continue with some form of legislation to allow people with pre-existing conditions to get health insurance.
Ruth Tamme, a social worker with Commonwealth Cancer Centers, sees the importance of health insurance in her work every day. She has seen patients diagnosed with cancer but who have no insurance walk out the door because they couldn't afford treatment.
Bill Phelps, who has lung cancer, said he thought about doing that himself. The 60-year-old logger from Liberty began to do contract work about 10 years ago, losing his insurance. He and his wife had coverage through her job for a few years, but not now.
The bills for his cancer treatment are starting to mount, and he thinks if the Affordable Care Act were to be repealed he'd probably never again have private coverage. Still, he's leaning toward voting for Romney who, he said, better reflects his overall conservative views.
Romney also has said he supports the popular Obamacare program allowing parents to keep their children on family health insurance plans until they are 26.
Kim York knows it can be helpful. Her older son, Brad Hall, now 28, aged out of coverage shortly before he needed surgery on his ear. The family paid nearly $3,000 out of pocket. York is glad her younger son, Jordan, is insured as he completes a master's degree at the University of Louisville. Kim York, who works as a program assistant for the Montgomery County Schools, and her husband, Tim, who works at Blackburn Correctional Complex, could have afforded the monthly premiums for Jordan's coverage without Obamacare, but it would have been a stretch. It's important that he have insurance while he finishes an advance degree because the economy is so tough, his mother said.
"Before if you had a BA it was great, but now they need the extra education. Hospitalizations and significant illness don't just happen to people who are older," she said.