WASHINGTON (AP) ? It took only a year to set up Medicare. But if President Barack Obama‘s health care law survives Supreme Court scrutiny, it will be nearly a decade before all its major pieces are in place.

And that means even if Obama is re-elected, he won’t be in office to oversee completion of his signature domestic policy accomplishment, assuming Republicans don’t succeed in repealing it.

The law’s carefully orchestrated phase-in is evidence of what’s at stake in the Supreme Court deliberations that start March 26.

The Affordable Care Act gradually reorganizes one-sixth of the U.S. economy to cover most of the nation’s 50 million uninsured, while simultaneously trying to restrain costs and prevent disruptions to the majority already with coverage.

Despite the political rhetoric about what “Obamacare” is doing to the nation, only a fraction of the law is in effect.

“We really haven’t seen the main game,” said Drew Altman, president of the California-based Kaiser Family Foundation, a nonprofit information clearinghouse on the health care system. “The major provisions that will affect the most people and cost the most money don’t go into effect until 2014 or later.”

What has taken effect in the two years since the law was enacted has produced both successes and clunkers, and some surprises.

Few expected a relatively minor provision tacked on late in the legislative process to be its biggest success so far. But allowing young adults to stay on their parents’ insurance until age 26 has added nearly 2.5 million people to the coverage rolls, at no cost to taxpayers.

Despite Republican pledges to repeal the overhaul, it’s arguably the Obama administration that has done more to scale it back.

Health and Human Services Secretary Kathleen Sebelius decided to pull the plug on a long-term care insurance program seen as a budget drain. She also decided that Washington would not dictate a basic health benefits package for the country, allowing each state to set its own, within limits.

Medicare recipients gained more protection from high prescription costs and better preventive coverage, but older people remain the age group most opposed to the law, concerned that cuts to the program to finance benefits for the uninsured eventually will compromise their own care.

If the Supreme Court overturns the law entirely, that would present an immediate dilemma about popular early benefits such as coverage for young adults and prescription savings for seniors.

“These provisions give immediate relief to a small percentage of people, but it’s a lot of relief,” said economist Len Nichols of George Mason University in Virginia.

Other early benefits have been a mixed bag.

Millions of people are getting preventive care that now must be provided at no additional cost to patients. Birth control for women soon will be on that list. Insurance premium increases are getting more scrutiny.

But a program of tax credits for small businesses has seen little acceptance. The administration is in the awkward position of asking congressional Republicans to help fix it.

A highly promoted program that provides a lifeline to people denied coverage because they already had medical problems has probably saved lives. But enrollment in the Pre-Existing Condition Insurance Plan has been disappointing, with only about 50,000 people nationwide.

Glenn Nishimura, a consultant from Little Rock, Ark., checked it out and found his premiums would come to about $6,300 a year.

“It’s out of my price range,” said Nishimura. It makes more financial sense to take care of his high blood pressure and high blood sugars by paying out-of-pocket and gambling that his health will hold up, he reasons. In three years he’ll be eligible for better coverage under Medicare.

If the health care law is upheld, it will bring some relief against such risks for millions of people such as Nishimura.

Starting in 2014, insurers will have to accept all applicants regardless of prior health problems. Also that year, many middle-class people will qualify for federal subsidies to lower the cost of their premiums. Consumers will have access to competitively priced private insurance through new state-based markets called exchanges.

At the same time, Medicaid would be expanded greatly to cover millions more low-income people, childless adults who do not now qualify.

Between the two approaches, more than 30 million uninsured people are expected to obtain coverage. Millions more will gain the security of knowing they can’t be turned down for health insurance if they switch jobs.

That’s critical for Natalie Hough, a college sophomore from Hillsborough, N.C. An aspiring artist, Hough has a heart condition that probably would make her uninsurable if she had to apply on her own later in life. Starting in 2014, insurers will not be able to turn away people like her.

“It’s definitely peace of mind, knowing that I can go to a hospital if I need to,” she said. “I’m an art major, and I’m not going to make billions of dollars.”

But such changes hinge on whether the law’s requirement that most people have health insurance is upheld by the Supreme Court.

This individual mandate, the main target for the law’s critics, also takes effect in 2014. Without it, many experts fear that the new exchanges, the state-based markets for private insurance, won’t work. Healthy people would be tempted to postpone signing up until they get sick, raising costs for everybody.

Administration lawyers have advised the court that if it strikes down the mandate, it also should invalidate the requirement that private health insurers accept customers with health problems.

If the court leaves the rest of the law in place, the Medicaid expansion could continue.

But even if Obama’s plan to expand coverage survives its test of constitutionality, expect the law’s cost-control measures to remain under attack.

One is an independent board that would have the power to curb excessive increases in Medicare spending by ordering cuts if Congress fails to act first. Republicans call it a “rationing board,” although the law specifically bars the yet-to-be-named panel from restricting access. The health care industry opposes the board; efforts to do away with it or diminish its role seem to be gaining ground.

“It would work like a random tax on medical innovation,” said economist Douglas Holtz-Eakin, a Republican adviser. “If you were an innovator, why would you want to bring something new to market when the biggest payer in the country is periodically lopping off spending?”

The other main cost-control measure is a tax on generous health insurance plans. Labor unions oppose it.

It won’t take effect until 2018, a year after a second Obama term would have ended.

___

Online:

Health care law: http://www.healthcare.gov/

Supreme Court: http://tinyurl.com/3zukoc4

Source: http://news.yahoo.com/obamas-health-care-law-trek-not-sprint-154209732.html

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WASHINGTON ? President Barack Obama on Thursday will free 10 states from the strict and sweeping requirements of the No Child Left Behind education law in exchange for promises to improve the way schools teach and evaluate students.

The move is a tacit acknowledgement that the law’s main goal, getting all students up to par in reading and math by 2014, is not within reach.

The first 10 states to receive the waivers are Colorado, Florida, Georgia, Indiana, Kentucky, Massachusetts, Minnesota, New Jersey, Oklahoma and Tennessee, the White House said. The only state that applied for the flexibility and did not get it, New Mexico, is working with the administration to get approval.

Obama said he was acting because Congress had failed to update the law despite widespread agreement it needs to be fixed.

“If we’re serious about helping our children reach their potential, the best ideas aren’t going to come from Washington alone,” Obama said in a statement, released before the official announcement later Thursday. “Our job is to harness those ideas, and to hold states and schools accountable for making them work.”

A total of 28 other states, the District of Columbia and Puerto Rico have signaled that they, too, plan to seek waivers ? a sign of just how vast the law’s burdens have become as the big deadline nears.

No Child Left Behind requires all students to be proficient in reading and math by 2014. Obama’s action strips away that fundamental requirement for those approved for flexibility, provided they offer a viable plan instead. Under the deal, the states must show they will prepare children for college and careers, set new targets for improving achievement among all students, develop meaningful teacher and principal evaluation systems, reward the best performing schools and focus help on the ones doing the worst.

In September, Obama called President George W. Bush’s most hyped domestic accomplishment an admirable but flawed effort that hurt students instead of helping them. Republicans have charged that by granting waivers, Obama was overreaching his authority.

The executive action by Obama is one of his most prominent in an ongoing campaign to act on his own where Congress is rebuffing him. No Child Left Behind was primarily designed to help the nation’s poor and minority children and was passed a decade ago with widespread bipartisan support. It has been up for renewal since 2007. But lawmakers have been stymied for years by competing priorities, disagreements over how much of a federal role there should be in schools and, in the recent Congress, partisan gridlock.

For all the cheers that states may have about the changes, the move also reflects the sobering reality that the United States is not close to the law’s original goal: getting children to grade level in reading and math.

Critics today say the 2014 deadline was unrealistic, the law is too rigid and led to teaching to the test, and too many schools feel they are unfairly labeled as “failures.” Under No Child Left Behind, schools that don’t meet requirements for two years or longer face increasingly tough consequences, including busing children to higher-performing schools, offering tutoring and replacing staff.

As the deadline approaches, more schools are failing to meet requirements under the law, with nearly half not doing so last year, according to the Center on Education Policy. Center officials said that’s because some states today have harder tests or have high numbers of immigrant and low-income children, but it’s also because the law requires states to raise the bar each year for how many children must pass the test.

In states granted a waiver, students will still be tested annually. But starting this fall, schools in those states will no longer face the same prescriptive actions spelled out under No Child Left Behind. A school’s performance will also probably be labeled differently.

The pressure will probably still be on the lowest-performing schools in states granted a waiver, but mediocre schools that aren’t failing will probably see the most changes because they will feel less pressure and have more flexibility in how they spend federal dollars, said Michael Petrilli, vice president of the Thomas B. Fordham Institute, an education think tank.

While the president’s action marks a change in education policy in America, the reach is limited. The populous states of Pennsylvania, Texas and California are among those that have not said they will seek a waiver, although they could still do so later.

On Tuesday, Education Secretary Arne Duncan said states without a waiver will be held to the standards of No Child Left Behind because “it’s the law of the land.”

Some conservatives viewed Obama’s plan not as giving more flexibility to states, but as imposing his vision on them. Rep. John Kline, R-Minn., who chairs the House Education and the Workforce Committee, said Thursday that, “This notion that Congress is sort of an impediment to be bypassed, I find very, very troubling in many, many ways.”

Duncan maintained this week that the administration “desperately” wants Congress to fix the law.

In an election year in a divided Congress, that appears unlikely.

Kline, speaking at an event at the conservative American Enterprise Institute, said that in the House there was some bipartisan agreement on how to fix No Child Left Behind, but in many areas there was disagreement. He said later in the day he would release Republican-written legislation that seeks to restore states’ authority in education.

California Rep. George Miller, the committee’s senior Democrat, has said such partisanship “means the end” to No Child Left Behind reform in this Congress. Sen. Tom Harkin, D-Iowa, who chairs the Senate committee on education, has said he believes it “would be difficult to find a path forward” without a bipartisan bill in the House.

A Senate committee last fall passed a bipartisan bill to update the law. The administration expressed concerns with it, and it did not go before the full Senate for a vote.

Source: http://us.rd.yahoo.com/dailynews/rss/topstories/*http%3A//news.yahoo.com/s/ap/20120209/ap_on_go_ca_st_pe/us_no_child_left_behind

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PORT-AU-PRINCE, Haiti (AP) ? The former Haitian dictator known as “Baby Doc” has been summoned to court to be scolded for violating the terms of his house arrest by venturing outside the capital, a judge said Thursday.

“Jean-Claude Duvalier needs to be in my office by 11:05 a.m.” on Friday, Judge Carves Jean told the Associated Press at his the courthouse office in downtown Port-au-Prince. “If he’s not, he’ll be arrested by 11:10 a.m.”

Duvalier’s attorney argued that his client wasn’t violating the law, because no such law exists. He also said he may file a complaint against the judge.

The law “is fantasy,” lawyer Reynold Georges said by telephone. The judge “can do whatever he wants but he also has to pay the consequences. I’m a snake. I don’t play.”

Duvalier faces criminal charges that include embezzlement, torture and murder.

After making an unexpected return to his homeland last year, Duvalier was placed under house arrest, meaning he wasn’t authorized to travel outside the Port-au-Prince metropolitan area without legal consent.

The former dictator, always dressed in a navy blue suit, has been seen traveling the country, often at the wheel of a SUV. He delivered a commencement speech to law school graduates at a university in the countryside last month and has been spotted lounging on the beach.

Duvalier attended a memorial service last week that marked the two-year anniversary of the devastating earthquake. The event was hosted by President Michel Martelly and guests included former Haitian president Prosper Avril and former U.S. President Bill Clinton, the United Nations’ special envoy to Haiti.

The prosecution of Duvalier has made little headway since it began last year and rights groups fear he will go unpunished.

Georges and the rest of the defense team argue there are no grounds to prosecute the former president because the statute of limitations on his alleged offenses has expired.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/cae69a7523db45408eeb2b3a98c0c9c5/Article_2012-01-19-CB-Haiti-Duvalier/id-f838496bcf7540a9aa6b996dc534ac79

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