this. >> from that to this. al jazeera's new look website. all the news that we have been covering there. lots of opinion and comment. aljazeera.com is the address. aljazeera.com. more than 30 million people are insured one way or the other under the affordable care act. but for house republicans coming this far down the road, doesn't mean the massive health care law is safely established or that the fight is over. for the 56th time the republican controlled house of representatives votes to repeal obama care. >> the reality is we are a company founded on the principle of government with consent of the governed.

no one was asking for this thing. no one wanted this thing. >> in everywhere this is working not just as intended, but better than intended. >> president obama makes his case inviting 10 newly insured americans to the white house. we'll be joined by one of his guests. who is signing up and why? the nuts and bolts and costs of a texas facilitator helping people to sign up before the deadline. don't forget the politics and policy are headed to a supreme court showdown. we have a new time and as you can see, a new home. it's "inside story". [ ♪ music ♪ ] even all these years after its passage there are parts of the health insurance law phasing

in, and still legislative and judicial attempts to dismantle the affordable care act. even with the shortcomings, and the widespread lack of cooperation when looked at state by state. there are fewer uninsured americans by the day. opinions are all over the place with many unhappy customers and millions of americans hostile. even as they tell researchers that there are many constituent parts. this far down the road, is it too late to derail obama care. >> no, it's not. >> again, they voted to repeal the affordable care act on tuesday. >> obama care has been a costly disaster to my constituents in the district of north carolina, and across this country. i have heard numerous stories ranging from young women to senior citizens, and they touch

on the same underlying problem. obama care is unaffordable and consequences. >> democrats were incredulous. they have seen this vote before and call it political posturing and point out that 19 million have become insured through the aca exchanges. >> this is working, this is happening. it's not something that we can throw away and republicans say they have - what did my colleagues say, the g.o.p. has no shortage of good ideas. what ideas. it's not funny that they received cancellation notices in the mail. a woman i spoke to can't go to a doctor she has seen for 20 care. >> president obama, of course, knew the vote was coming and was ready. he brought 10 people who got insurance through aca to the white house.

>> so my understands is the house of representatives scheduled another vote today to take health care away from the folks sitting on the table. i don't know whether it's 55th or the 60th time that they are taking this vote. but i asked this question before. why is it that this would be at the top of the agenda. >> joining us now is ann chrisman, a self-employed mother of three that went for years without insurance and bought coverage under the obama care and joined barack obama at the white house to talk about the new experiences with the health care law. welcome to "inside story". why did you write the president? >> i wrote the president to tell himle story about how it impacted my life and thank him for literally saving my life, for bringing the bill to fruition, that it was passed. >> saviour life how.

-- save your life how. have you been without insurance for a long time? >> i've been without insurance for five years. >> did you roll the dice and hope your health stayed good? >> i mostly rolled the dice and yes. >> when you say saviour life when you were covered did you get care and find ut you needed it. >> i did. i had a physical and a mammogram. the mammogram showed i had stage 1 breast cancer. it would have metastasized and gone into the lymph node system. i was able to catch it early. i didn't do it, or get into the lymph node system. i had two surgeries and radiation treatment.

a far less treatment, really, than if it had been continued on without my knowing about it. i might even have - you know, it was good to catch it early, because rate. >> you mentioned you had a couple of kids. are they falling in under your insurance, are you carrying them under your plan. >> they do. >> are they healthy, is everything okay. >> they are very healthy. it's a great relief. >> there you are at the white house. something you perhaps never expected to happen. what was that like? >> well, it was - it was just an incredible experience meeting the president and sharing the day with nine other people who had really wonderful stories of how the affordable care act really profoundly impacted their

lives, and to meet the president and see his compassion, but also his strength and his ability to rationally approach an issue and tackle it. >> do you live in a state that cooperated with the plan and opened its own exchange, or did exchange? >> my state, connecticut has a wonderful - it's called access health programme. and they were - there were news broadcasts constantly during the enrolment period, and i found out how to call a navigator to process. >> how to call a navigator. it's not so easy to go on and figure all this out by yourself. >> the navigator helped tremendously with the process. >> what do you think about what

is going on in washington. you are visiting the capital, and on the day you are here, congress decides it's going to take down the bill again, that you think saved your life. >> well, we are here in part to put a personal face to how the affordable health care act helped many of us. i'm here to spread the news what a great programme it is. and it would profoundly impact my life if it were repealed. so i'm happy to share with you in what ways. >> now it's no secret to you that tens of millions don't like the law. are you kind of an evangelist when people say "oh, obama care, it's terrible", do you pipe in and say "here is how it works

for me?" >> sure. i haven't encountered that many people who have spoken out against it. i want call myself an evangelist, but i'm in favour of the law. i would defend it. absolutely. >> great to have you with us. welcome. washington. >> thank you very much we'll be back with more "inside story" after this short break. when we return, apart from the politically driven debate that sings the glories of obama care, or calls it a disaster, what is the daily working reality of the law. is it bringing financial hardships to american families? protection from ruinous increases in premiums? or does the answer depend on who you are? stay with us - it's "inside story".

welcome back to "inside story" on al jazeera america. i'm ray suarez. next month the supreme court will hear arguments in a case that could jeopardise a major tenuate of the affordable care act. the federal subsidies that make buying health insurance affordable. should the court rule against the administration. as many as 8 million living in the 37 states could lose the subsidies, forcing them to pay more or effectively ending their coverage. all along congressional republicans insisted the mandate is a mistake and the law as promise. >> right now americans are forced to buy a government product or buy apenalty. the constitution mandates freedom. obama care must be repealed and replaced.

the americans should be able to provide the insurance they want or need. people should be able to buy health insurance across state lines. since the aca was passed and since it's gone peace by piece into effect. there has been debate about the design, whether it would work, forcing people into the overall insurance risk pool by creating a mandate making insurance affordable. whether peel compare or shop effectively. joining us to look over the operation of the affordable care act, are election culvin, director of insure central texas, and cc conley, managing director of pwc's health research institute. >> you've been on the show before. we had you earlier on in the enrolment last time around. how is it going this time? >> it's going well. so far we enrolled 3,000 period.

>> is that what you expected? >> we didn't know what to expect. last year we enrolled 5600 individuals, expected a rush, hoping to achieve the same number this year. >> do people, first starting out, have a better idea of what they are getting into when they sign up. >> people have a better idea this year than last year. there was miss information last year. people are better educated. friends and family had better experience. people are more interested in the plan. >> do we now how many of the new sign-ups are a net increase in injured americans, rather than those that had health care one way for the other. >> we get numbers from a number of sources.

many says have their own exchanges. we have a sense that sitting here today about 10 million signed up through this. a portion of that could be 6.5, 7 million could be reenrolment. as you know two weeks to go until the deadline for the '15/"16 season. >> do we know if some of the central promises of obama care are coming through. the president said that his intent was to bend down the cost curve. premiums went up every year, sometimes by double digit amounts. has that happened? >> we know medical inflation has been slowing over the last several years. it's difficult to give the affordable care act credit for much of that slowdown of more of

it is tied to the germ economy. as we had the recession in 2008 and came out of it that affected spending growth rates. it's difficult to say that the law reduced our health care spending in this country. a couple of little improvements but not a major shift in cost. >> after the window for the last period closed, public opinion researchers went out and talked to people that tried to use healthcare.gov and found many didn't know what a deductible was or different levels of out of pocket obligations, that it was hard for them to buy health care, because they had never shopped for it before. how do you help out? >> we found that. there's a lot of health literacy that needs to happen. we spend a lot of time educating

the customers on how the deductible works, what is a deductible, what is coinsurance, and that is half the visit they spend, the education. we are open year round. people come back to us every bill. saying "what is this for?" what is this explanation of benefits. we help people to navigate the system. insurance was confusing before the affordable care act. our role is to help those without insurance figure out how to use it. >> are there times where somebody saves money by choosing a more expensive plan because they qualify for more subsidy. >> absolutely. someone had an option to get a plan with zero premium, but it had a $6,000 deductible, out of pocket maximum and is wouldn't feel like you had insurance. she could spend $10 and buy a

silver plan, and with that she had $500 deductible. $750 maximum. mum. she's spending more but is getting rich subsidies at the silver level. versus cheaper on the front end. >> subsidies are in the cross hairs of that supreme court case. can the affordable care act as we know it stand if the supreme court rules against the administration is this. >> it's hard to see how that could happen. right now we are talking about, as you reported, about 37 states that are using that federal exchange. if the supreme court rules later this spring that those are not acceptable for putting the subsidies through, you will have somewhere between 6 and 8 million individuals who will lose subsidies. as elizabeth pointed out, they are significant sums of money to

the consumers who tend to be low to middle income. they'll drop coverage or not pay the bills, and you are also looking at what happens to the insurance companies that have had the customers, do they lose them over night. >> elizabeth, is that your experience, are you working with people that simply would drop health care subsidy. >> yes, they would not be able to afford it. this young woman, without the subsidy, it would cost $179. she's makes less than $12,000. this is because you are in texas, a state that chose not to make its own exchange. people are buying through the federal exchange, right? >> correct. >> so what are you telling them. is that part of this counselling

process as you navigate them through the system, the idea that it's a fragile game. >> we are trying to encourage people to enrol. we expect people to maintain the insurance. we hope it happens in terms. supreme court ruling. >> now, these states, some of them have opted in to the medicaid, the expanded medicaid. >> right. >> many have not. what happens if the whole system is thrown into chaos by a court ruling. what happens to those rulings. do we know what happens if the supreme court rules in that way. we are not expecting medicaid to be affected. the supreme court case is focused on the subsidies. as you point out in a number of

states, including where elizabeth is in texas, that chose not to dedicate expansion, you are looking at large numbers of uninsured americans. then we are back to where we were before all of this, where you see the people showing up at the emergency department, in worse health because they haven't had check-ups or screenings, or a story that you heard earlier from ann about catching breast cancer earlier. that will not be the case. >> i understand that in many cases these are people not affected because the states didn't participate. isn't part of the way the system works, a series of payments that flow in different directions from different pairs and holders that make the vast expansion system. >> yes, that is certainly the case.

you have the money coming in from a number of different sources depending on the individual and when and how they are qualifying. traditional medicaid is more of a joint federal state programme. you have a lot of those individuals. with the group of americans, they move from one category to another. they may lose a job, qualify for medicaid. get a seep -- seasonal job and shop on the exchange. this is known as churn. and you have people and money moving behind the scenes. >> we have about a week and a half left before the window close, will you stepping up for the late rush. >> we are opened seven days a week, we are encouraging people to come in. we are expecting a big rush

before the deadline. both. >> still ahead on "inside story", however difficult the establishment of health care exchanges has been across the country and however little cooperation the white house has gotten, the exchanges are signing people up, and the people in their millions are getting health care. if the congress succeeds, what would they want to put in their place and will it begin in earnest after the law is dismantled. stay with us, it's "inside story". >> on the stream >> february marks black history month but is it time for a refresh? a look at why african americans are turning to twitter to discuss the issues their local communities won't >> the stream on al jazeera america

welcome back to "inside story" on al jazeera america. i'm ray suarez. as we mentioned earlier in the programme this week, the house of representatives tried again to repeal the affordable care act. it's unlikely any of the house members who pushed repeal think

that if the senate were to go along that the president would sign such a bill. why do they do it. what is the house up to. have they got anything to put in obama care's place. joining me in studio is louise from the "wall street journal," what are they thinking, do they think this is the vote that will act? >> it's important to a number of members of congress to cast a ballot putting them on the record. a number have told their constituents that they were going to come to washington to do. that said, what congress is pinning its hopes on at this point in changing the affordable care act, which republicans who control the senate and the house want to do is a supreme court case in march. if that case is successful, a lot of people, as we discussed earlier in the programme, are probably going to lose the insurance they have gotten through the aca. is the pressure growing on

republicans to have a viable alternative, a replacement for the affordable care act? >> there's a lot of pressure on republicans, and they, themselves, say they feel under pressure, recognising that there would be a situation that would be chaotic. they don't thing the solution is to fix the law. they'd likely want to use it as an alternative. they have to figure out what that is. >> they note many of the things that their constituents are telling them that they like. until 26-year-old kids can stay on the health care, you can't be capped if you get an expensive illness, you can't be denied. isn't there going to have to be some version of subsidy to make the numbers work if they want to keep those things. >> there's not a possibility that anyone raised that you could require people to have insurance. keep them available and not subsidise

some to buy it. republicans are talking about the way they would like to sub siddizes people, through tax credits, and some like to keep options on a table. they have never had to co--al esque around a single idea, and the supreme court may make them do that. >> aren't they feeling that they have to come up with something, at least a framework to turn to the public and say here are the outlines of what we would like to do. >> they do. and they have to have something saying they have a large number of ideas, and it is complicated, now, they would say that they have until june, which is when the supreme court is expected to rule. and they don't necessarily have to come up with all the answers, they don't know what position they'll be in. people are asking the question. >> is it safe to assume there's

a lot more votes to repeal in the senate than there were a couple of months ago. >> there are a number of votes. it's worth noting the moderate democrats who were in the senate are not there in the same numbers they were. changed. >> numbers have changed. it's not veto proof. >> probably not. it depends what the senate was trying to do. it doesn't seem clear they have the votes to do something that has consensus among people that the medical device tax that some democrats dislike. it's a revenue raiser. the white house wants to keep it there. it's an issue that you think there was broader base support on and the votes are not there yet. that's an uphill climb. >> thank you, great to see you again. thanks. thank you for joining us for this edition of "inside story". get in touch on facebook, follow us on twitter and watch us next time. in washington, i'm ray suarez.

>> joint military exercises between united states and south korea are regular occurrences. this one, codenamed max thunder - took place in november at the kunsan air force base 150 miles south of seoul... >> this type of exercise takes place every year but for the north korean