there is no stigma of welfare here. anybody who wanted treatment could get it, as things stood before obama care ...
That's not accurate, I'm afraid. People can get emergency care at hospital emergency rooms because, by law, those hospitals are required to provide it regardless of the patient's ability to pay. Those costs are recovered by hospitals by charging higher prices to other patients.
For example, if you are taken to an emergency room after an auto accident, you will be treated, whether or not have insurance or can pay out of pocket. Then you will be discharged.
If, however, you break a leg in that auto accident, and need long-term rehabilitation and physical therapy, no requirement exists -- even with the new law -- that someone who can't pay for it and who lacks health insurance must get that treatment. They're on their own.
Another example: Someone suffers a stroke at home. He's rushed to the emergency room. He's got no insurance. No matter, he will receive emergency treatment for the stroke. Then he will be discharged. No more freebie care will be forthcoming, which means he's on the hook for all the follow-on care and treatment that happens after a stroke. It also means the hospital will not be required to admit him if he cannot provide evidence (insurance) that he can pay for it.
Ditto for someone who goes to an emergency room complaining of intense headaches. If the emergency room diagnosis is a brain tumor, he's on the hook to pay for the treatment.
Bottom line: If you can't show ability to pay, your treatment ends when the ER discharges you.
The important question to ask about any insurance policy, whether it costs $10 in Alabama or $10,000 a year elsewhere, is what is covered and when and why the insurance company doesn't have to pay a claim.
There's nothing in the new law that means those Alabama parents can't buy that $10 policy for their kids. Those Alabamans who already have health insurance won't do anything different. And anyone who can't afford to buy health insurance will be provided subsidies so they can.