daughter's best interest. daughter suri was born in 2006. she is the couple's only child and katie wants primary custody. this is just the beginning of this story. coming up next hour we'll talk with famed hollywood attorney about the split and the legal challenges that come next, like the prenup and possible custody battle. i'll be back with more on that and more headlines at the top of the hour. "your bottom line" starts right now. the supreme court has spoken. obama care is upheld. so why does it still feel like we're at the beginning and not the end. good morning, everyone. i'm christine romans, for starters ugly politics of the health care debate have totally swamped challenges we still have in health care. this was always meant to increase coverage, access to health insurance. it doesn't mean lower cost or better health. take a look. the u.s. ranked dead last in a study of seven nations according

to a report by the commonwealth fund. the report looked at factors such as quality of care and access to care. but look at the cost. if you combine the per capita cost of the two nations on this list, netherlands and uk you still don't equal costs. they have been soaring long before object care and it's continued to rise in the two years since it became the law of the land. in other words, like a lot of things with this president, he didn't cause the problem but hasn't fixed it either. republicans not willing to give up the fight over health care despite the supreme court decision. the message before and after the ruling is crystal clear. >> i will repeal obama care. >> we need to repeal obama care. >> repeal obama care. >> only one way to truly fix obama care, only one way, and that's a full repeal. >> repeal and replace. but replace with what?

republican randy forbes of virginia was actually a few people inside that courtroom when the historic decision was announced. congressman, thanks for joining us this morning. >> thank you. good to be with you. >> the republican committee put out a 27-page document containing more than 200 pieces of health care legislation proposed by republicans. 200 pieces of legislation. i read a lot in this. i read a lot about abortion, tort reform, appealing it outright, but i don't see anything that deals with the overall problem of lack of coverage and diminished quality in return for the world's most expensive health care. if obama care is repealed, what replaces it? what replaces it that is better, sir? >> well, christine, i think we have to start with the fact, what did we get from obama care. as you just mentioned when obama care was passed, we were told we were going to have better access. when lou in point of fact we have less access. we hear doctors saying they are leaving the system and we won't

have access needed for treatment. second thing, our costs are going up, not down. we believe there's a series of things you could do. one of the things we think we should do is keep some of the provisions that make sense, like not penalizing people for pre-existing conditions when they are getting health insurance. >> we are keeping those because the supreme court has ruled we're keeping those things. this is the law of the land. honestly, it has been ruled this will be -- wouldn't it be better if people would spend less time adding to uncertainty about what's going to happen next, instead educate constituents and small businesses about how to adapt to the mandates. >> christine, that would make sense except for the fact as we travel across this country, we realize with this bill we're going to lose thousands of jobs. that's what we're told by employers, not pontification. >> give me the evidence, the one piece of evidence that says that. >> the best evidence is from the mouths of the employers, christine. if you ask employers across the country, we are seeing not just a few but literally thousands of

them telling us every place we go, they are not going to expand their businesses. some cutting back, a job killer, they can't afford tacks the supreme court says they put on them. the second thing important to remember, the supreme court didn't say this was a good bill. they said it was a constitutional bill. justice roberts made it clear. this court wasn't going to protect us from bad political decisions of our elected leaders. obama care was a bad political decision. that's why it's important, not just rhetoric. important if we're going to create jobs in this country that we not continue to pass legislation that's doing to kill those jobs. the second thing, it's important we get health care to people. we can do a much better job selling insurance across state lines, get costs down. also we would put more money, i would, on medical research which i think could change the health care curve much more than we're doing. >> let me bring in governor romney here. he says it's up to the voters to repeal obama care now. >> this is a time and choice for american people. our mission is clear, if we want

to get rid of obama care, we're going to have to replace obama. my mission is to make sure we do exactly that. >> if president obama wins in november, are you ready to concede the president signed a law, supreme court upheld it and voters endorsed it. so then will you move on? >> christine, i don't think that voters are going to endorse it. just because the president signed a law into effect doesn't mean it's a good one. this president also wants to have billions in defense cuts. we're going to continue fighting those. just because the president signed it into law doesn't mean it's good law. i don't think obama care is good law. it's incumbent on us to change it and make something that will work for american people. >> in the end, as much uncertainty today as a week ago? isn't uncertainty the thing gop was saying is the problem with obama care in the first place? businesses and people didn't know how to handle mandates. >> christine, as you know, when democrats voted and passed it out, a lot of uncertainty. you remember the famous phrase

they had to pass it before they would know what's in it. >> that's ancient history. the supreme court has ruled on this. it's been two years since it happened. shouldn't you be helping your constituents understand, telling people what mandates are, small businesses 51 people or more will have to pay a fine if they don't figure out how to get people covered. only 4%, over 50%. speaking about exchanges, shouldn't we be educating instead fighting about it. >> christine, the more they find out about this, the more they are opposed by this. whether you talk to doctors, whether you talk to heck providers, hospitals or small businesses, the more they find out, they more they realize this is a bad decision and they want it overturned. i think that's what we're going to see them doing in november and that's what we're going to continue to fight to make sure happens. >> appreciate you coming by. we'll talk more in this program about what small businesses in particular need to do and how they need to start planning now for this. congressman, thank you so much. have a nice weekend.

they are the most vulnerable players in the bitter debate over access to affordable health care, children with a pre-existing medical condition. >> we found out about cam's disorder in an odd way, because of family history particularly on my side of the family and some early death from heart disease and known high cholesterol, including my own. we decided when he turned two to have his cholesterol tested. they discovered his cholesterol was already, i'm going to say, somewhere between 5 and 600. >> what the supreme court ruling means for little cam and his family next. check out our new mobile app. now you can use your phone to scan your car's vin or take a picture of your license. it's an easy way to start a quote. watch this -- flo, can i see your license? no. well, all right. thanks. okay, here we go. whoa! no one said "cheese." progressive mobile -- insurance has never been easier. get a free quote today.

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before the break we introduced you to this family. their son cam was diagnosed with a rare and deadly form of high cholesterol. he's diagnosed at 2 yeerds. that's considered a pre-existing condition. what if this happened to your family? should it be covered? will it be covered? the supreme court decided and the answer is yes. the host of sirius xm's dr. radio. nice to see you and little kamas well. tell me what is the intensity of his medical care you're doing. i know he's under your husband's insuran insurance. how often is he going to the doctor? what kind of procedures is being done? >> he's normally in the hospital

once a week for a procedure that filters ldl and purifies his blood. it's an intense procedure. at the moment he's not doing ldl because we're on a drug study to see if they can make some headway with a drug rather than the ldl procedure. >> what a brave little guy. we have pictures of him as a toddler and now getting older. this is obviously a pre-existing condition for him. if your husband were to lose his job or insurance, this would have been an issue for you. the supreme court's decision gives you breathing space. >> i think yesterday, i was asked what my reaction to the decision was. i said it was a mixture of relief and hope. i think it is the right decision for not just our family but all americans to have this certainty that if you have a serious medical condition you can always get covered. >> want to bring in andrew reuben, clearly a victory for people with pre-existing

conditions. there's still uncertainty hanging over this legislation, at least in an election year, for people with pre-existing conditions. the supreme court has set this aside. they will be recovered. >> health care reform whether it's survived or not, hospitals and doctors were preparing for this, we have to find a way to take care of patients in a more cost effective setting. what this portion, gave little boy cam hope and protected, that he and so many other americans didn't have. >> this means kids are going to get covered no matter what. someone is paying for that. he has expensive medical care. >> sure. not a lot of centers around the country that have this treatment. it's expensive, every two weeks to cam, 25 to $3,000 per treatment. can you do the math. the drugs and doctor visits on top of this. it's expensive. this will give all american families the opportunity onhave this on their insurance, no annual caps, lifetime caps. until there's a cure for this, this is going to be very expensive to treat.

there are state medicaid programs and federal programs, medicare for disabled people but sometimes access is a little difficult in those situations. i think most person families would prefer to have people like cam stay on their parents policy. >> your husband's insurance has been good, right? you've been happy with the employer-based coverage you've had so far? >> we've had excellent insurance coverage over the year and actually have been with the same provider since cam was diagnosed. it's a company in minnesota called medica. they have been an incredible partner in this journey and have done whatever they can to cover what we need for cam. >> if you would have to go out in the open market and buy insurance because of health care reform, you would be able to go to a state exchange, minnesota state exchange i guess and you'd be able to buy a plan and your son wouldn't be penalized for having a pre-existing condition in terms of price. right? >> that's what i understand, yes. >> you have options. you have options should your employment change. that's interesting, andrew.

a lot of times in this country your insurance comes with your job. through health care reform, i think a lot of people don't understand, now your insurance doesn't have to be only tied tower job anymore. >> absolutely. i was reading an article on cnn money website where they talk about people who don't leave their jobs, don't move out of state because they are afraid of losing their insurance. now, people are going to hear a lot in the news about whether employers will trop them from insurance plans, what's going to happen. governor romney saying one thing, president obama saying another. >> a lot of politics. >> what it basically means. no one knows the future. what it really means for the short-term is people are going to have health insurance. >> if your name is cam, high cholesterol problem as a preexisting illness, you will be able to have health insurance in this country. marlin a marla, would you give our best tower son. >> i will. up next, a health insurance coe advising the president on health care reform. a supporter of the mandate but since changed his mind.

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my next guest had a front row seat as an adviser to the health care legislation. eventually he broke with the president over the individual mandate, which the supreme court upheld with the rest of the law this week. ron williams is a former chairman and ceo of aetna, one of the country's largest health care providers. welcome to the program. >> thank you. it's a pleasure to be here. >> were you disappointed with the supreme court's decision? >> no, actually, i was not. i would have been disappointed if the supreme court had upheld the mandate utilizing the commerce clause. my biggest concern i did not feel as a citizen that the commerce clause was an appropriate application. given that the court interpreted it to be a tax, which i think the legislation was fairly ambivalent and i think we all know the public statements about it. the fact that it's a tax and the

court ruled it's well within the power of congress, i'm fine wit. i think the mandate is something that can work. there are lots of other choices that have worked. i think it's worked well in massachusetts. i would have been a supporter of more choices for states to make other decision toss achieve the ultimate objective. >> when you say it can work, you mean it will get everybody covered and people can have affordable health care? >> well, i think the answer is it provides a path to access. when you think about the mandate, they are roughly about 7 million people in the u.s. for whom the mandate would actually apply. those individuals would either have to buy insurance or be subject to the mandate as a tax on their income. >> do you think that employers in droves, as some republicans have suggested, are going to start dumping -- basically dumping their workers from their own health care insurance rolls and pushing them onto exchanges?

that's one of the complaints. they think employers will stop eventually providing insurance for their employees? >> i think what we're on is a journey. i don't believe employers are going to take any sudden precipitous action, particularly large employers. i think don't offer coverage, that there will be an incentive not to offer coverage because their employees will be able to get it through an exchange or through a medicaid-type program. and i think for employers who are facing really difficult economic decisions, they may very well be an incentive to not offer coverage. i think we'll have to wait and see how it plays out. >> you know, it's interesting, in this country there's a feeling that what's good for the insurance companies must not be good for the public. true or not, that is the perception. do health care costs and quality have to be a game? is there an intersection of interests here? can we change that perception? >> i think absolutely we have to change the perception. insurance companies don't have a business if health care is so

unaffordable that no one can buy it. when you think about how much money the u.s. spends on health care, today we spend about 17% of our gross domestic product. projections are that we'll spend about 21% of our gross domestic product in about ten years. that means we would go from spending $2.7 million to spending about $ -- excuse me, $2.7 trillion to $4.7 trillion. that's $2 trillion more. >> wow. >> i think the health industry, health insurers can play a fundamental role in improving quality and a fundamental role in digitizing the system, and really, also getting patients and members engaged in their own wellness. >> yeah, that's important. getting engaged is so important because a lot of people still don't even understand what's in this law that is now the law of the land. ron williams, thank you so much. nice to see you, sir. have a nice weekend. >> thank you. up next, the truth about what the affordable care act means for small businesses. a fact check on what the legislative will actually mean for jobs. [ manager 1 ] out here in the winds,

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if you believe obama care haters, american jobs, millions of them, will be lost, and small businesses will go under. >> obama care is a job-killer. >> the president's health care law is driving up health care costs, making it harder for small businesses to hire new workers. >> millions of jobs are about to move out of the united states. >> a gop battle cry in unison, but is it true? the law mandates employees with 50 employees or more must provide insurance. of about 6 million employers in america, that's 200,000 businesses. simple math -- obama care affects 4% of small businesses, 4%. if you have fewer than 25 employees and you decide to offer health care, it is not a mandate. but if you decide to give them health care, you get a tax credit. to qualify for the credit, the average salary at your small

business must be $50,000 a year or less and you've got to cover at least half the cost of health care for each of your employees. and what if you don't comply? well, then there are fines. if you employ 51 people and don't insure them, you pay at least $40,000 in fines. it's new rules, new mandates. small business owners say they're concerned about the changes, yes. in a survey done by sure payroll, a quarter of small businesses said obama care would hurt them, 53% thought it would have no impact, while only 19% thought any impact would be good. yet, there's no solid evidence that small businesses are firing workers because of obama care. of roughly 120 small businesses surveyed by "cnn money," none, none had fired a single employee because of the affordable care act. i want to bring in ali velshi, chief business correspondent, host of "your money." it's about as clear as it can be. >> yeah. >> there's no real evidence that obama care or this health care law has caused anybody to fire anybody. >> right. >> but small businesses are concerned. >> yeah, but look, small

businesses, very fairly, have reason to be concerned about a lot of things. they're concerned about uncertainty. small businesses depend on the ability to plan for what's going to happen, and there was uncertainty about whether this law would take place. now that this law has been approved by the supreme court, there's uncertainty as to whether -- >> do you think it's a job-killer? >> first of all, michele bachmann said, and several times during that interview you used a clip of, millions of people, millions of jobs, millions. we hardly lost millions of jobs in the entire financial crisis. that's just entirely, entirely false and untrue. what would be better is to try and make people understand how they budget for this, how do they do this. there are definitely some businesses that will feel the impact of this, but it is not necessarily a job-killer. >> so, here's -- if lawmakers spent half as much time educating their constituents on how to meet the new rules and mandates -- >> right. >> -- as just saying this is going to kill you as a business -- >> right. >> -- we'd be better off? >> well, you can apply that to pretty much anything we ever discuss. if lawmakers spent more time, and the administration, by the way -- >> i've been calling politics a

precondition. >> this, i think the republican rhetoric is remarkable on this, and they should stop and start doing something else, but the administration dropped the ball on this the minute they announced health care. they should have said much more clearly, it's there. you can dig around on the internet, you can find it. >> one team has a honed message and one doesn't, since the beginning. >> right, the honed message is not correct. the bottom line is businesses have to plan for something, right? they have to plan. you can't run a business on the basis of what the next three months are going to be. so, they should plan for what their costs will be as you just described and worry less about whether or not it's going to kill jobs. for an independent business, small business, you can't worry about the macro as much as you've got to worry about what faces you. >> and demand is about demand. they want demand. >> now. >> they want demand. >> the net effect of this health care law, if it is done the way it's supposed to be done, might actually create demand. it might actually put more money in people's pockets. we're yet to see all of this stuff, but i just wish the conversation would switch from the one that it is, about how this is a massive job-killer, into what impact it's actually

going to have. >> ali velshi, have a nice weekend. before i leave, i wanted to share some points that have been lost in the ugly politics of the obama care debate, a debate that's totally swamped some important challenges we still have in health care. this is the beginning, not the end, of an important national mission to fix a bloated and inconsistent bureaucracy. here's what the ugly debate did not settle. this was always meant to increase coverage, access to health insurance. it doesn't mean lower costs or better health. here is still what we have to do. there's no meaningful malpractice reform. insurance companies are not forced to compete on state lines. there was no meaningful discussion of end-of-life issues at a time when we have an aging population. instead, we're at a moment in american politics where this complicated and emotional issue is reduced to a death panel bumper sticker. 70% of health care costs are associated with lifestyle choices, by some stimtestimates. how do witness we incentivize people to take care of themselves? consumers have no idea how to bring their costs down.