Health or wealth? It's your choice - MarketWatch

BOSTON (MarketWatch) â€" The Supreme Court decision to uphold most of the Affordable Care Act probably shouldn’t change the answer to a major financial question: Which would be worse, losing your income or losing health-care coverage?

It’s a tough question, because income is obviously more important on a day-to-day basis, but the lack of medical care takes precedence in the event of a critical illness.

The Supreme Court’s decision on Thursday mandates health coverage for all Americans in 2014 â€" and requires taxpayers to pony up for care or face fines for a lack of coverage. But there’s a long road ahead until then, and it’s too early to assume that the health-care provisions will take effect as written. Read more: Supreme Court upholds health-care overhaul.

Meanwhile, Americans face a high unemployment rate, real concern about the loss of income and problems that could be caused if their health insurance lapses.

Financial advisers say that everyone should evaluate the health care vs. income question and consider how it plays out in their lives, then decide whether they are adequately protected.

“One of the most common things we hear is ‘I cannot consider retirement before age 65 because of health insurance [Medicare],’” said Dan Dorval of Dorval & Chorne Financial Advisors in Otsego, Minn.

“Many people have always had coverage through their employer and cannot envision a time when they might have to pay for coverage on their own,” Dorval noted. “They have been conditioned to assume their only option is to transition directly from employer-provided coverage into government-provided coverage in the form of Medicare. When we explain to them that they can purchase coverage on their own, they look at us like we are speaking a foreign language. “

No easy fix

One reason for that is because health-care coverage is not cheap.

While the new law will make health coverage available to all, it won’t necessarily make it dramatically less expensive. Insurers will now have to make coverage available to people with pre-existing conditions who might not have qualified in the past; in being forced to issue those kinds of policies, expect insurers to raise costs across the board. The insurance exchanges coming in 2014 will help, but the only way there will be bargain-priced health insurance is if it comes stripped down, with significant limits and endless disclosures so that consumers are aware of the inadequacies they could face.

Further, the Supreme Court ruling kind of gave consumers a price point for making a decision, where they can decide if they are better off paying the fine that comes from being uninsured or paying health-care premiums. Read more: On health care, it's the costs, stupid.