Shortly after the U.S. Supreme Court upheld the health care bill in a 5-4 split decision, with Chief Justice John G. Roberts Jr. providing the swing vote, some in Loudon County did not know how to respond to a law that will impact nearly every American.

"I haven't had any time to sit back and analyze it in some depth and form my own personal opinion on it," John Hirzel, chairman of the Loudon County Republican Party, said. "It was a very complicated bill, and the judges' decision seems to be pretty complicated too, so I just need time to read about it."

Hirzel said he was in no position to comment further.

The bill requires each American to obtain health insurance or pay a penalty. In part, the Supreme Court took up the question of whether Congress had the power to issue a tax in the form of a penalty for failing to get health coverage. With the ruling, the high court affirmed that power.

The court also limited the expansion of Medicaid, ruling that Congress can't force states into participation by threatening to take away existing federal funds.

Keith Buckles, District 5 member of the Loudon County GOP, said that while he has not had time to digest the decision fully, he was disappointed the law was not tossed out.

"I think it will put an extra burden on small businesses, and I think they will reconsider expanding businesses and growing their employment, so I am concerned about that," Buckles said. "I'm concerned that they will not continue to expand and increase their employment, therefore continuing our downward employment rate."

He said the entire health care package was a negative, adding that he did not agree with the process by which it initially passed in Congress.

"I'm completely negative on this Obamacare, and I don't even like the process that it was put into law," Buckles said.

Meanwhile, Loudon County Democratic Party chairwoman Dixie Damm could barely contain her excitement. She said she was sending an email to supporters encouraging them to extend a "thank you" to Chief Roberts.

News reports initially projected Roberts might provide the fifth conservative vote that would rule the health care bill unconstitutional.

"I'm certain that man, Chief Justice Roberts, spent many nights debating his decision," Damm said. "Oh, I'm going to choke up now. I am so thankful that he came down on the side of humanity."
She was relieved the court upheld the law because of what it means for relatives and local residents who benefit from the plan.

"I guess part of the reason that I'm so emotional - I have grandchildren," Damm said. "Their parents are not comfortably situated. Those grandchildren need this bill, so it's a good day filled with lots of emotions."

She said that deep down she believes average Americans wanted some type of health care reform.

"When you get to the real John Q. and Mrs. John Q, they want some kind of settling to the health care," Damm said. "We know it costs jobs. We know it pays too much money to CEOs of the insurance companies, but, of course, we can't say that because it wouldn't be politically polite. We all want the same thing. We really do."

Mary Danielson, with Blue Cross Blue Shield of Tennessee, said in an email correspondence that the insurance company has been a long-time advocate of health care reform.

"We recognize people want and need affordable health insurance, and the law helps expand coverage to thousands of our fellow Tennesseans," Danielson wrote. "That's a goal we believe in, and one we'll continue to support by implementing the law in a manner that best benefits our members and the state."
She said Blue Cross would continue to work to change certain parts of the law, like a health insurance tax she said will raise premiums for customers.

"Working with policymakers and other Tennessee health care leaders, we'll also continue to push toward delivery system reforms and solutions that reduce costs and improve quality," Danielson said.

Joe Nowell, with East Tennessee Discount Drugs in Lenoir City, said that while his pharmacy would continue to serve its customers with "excellent care" regardless of how the issue unfolds in the coming months, he was for individual freedom.

"We make our own decisions and to have the government, to have Big Brother, tell us what we can and can't do is a problem," Nowell said.

When asked if he saw clear problems within the current health care industry, he said, "Oh, absolutely," noting that it was a challenge working with insurance companies.

"They pay. They don't pay. They deny, and our concern is with the patient," Nowell said. "It's like if we call an insurance company and say we've got a child here that's missing a spleen, and we need such and such, and they're like, 'No, you're not going to have it.'

"It's like, 'I didn't ask you. You need to pay for this. They contract with you. You need to take care of your patient,' and they don't see it as a patient," he said. "They see it as a number."

Based on interaction with customers on a daily basis, he thinks people are generally more concerned about their acute financial needs, like gas prices, rather than sweeping reforms in health care.

"The talk is with the industry-wide," he said. "I don't have many patients coming to me asking about it. I don't think they realize what's at stake. If the gas prices are going up, they're talking about that, if it directly impacts their pocketbooks. This one doesn't seem to bother them as much."