Paxton admitted that he didn’t understand the new law, but it worries him all the same. “There were way too many compromises made to get it passed. You know it’s not going to do what it should.” His specific worry: “My benefits could become less and I could have to pay a larger portion of (the premium) for my benefits.” Each pay period, he and his wife, who also works at the university, have $170 for health insurance deducted from their compensation. Paxton says that amount will increase because of health reform.

He said it sounded like the new law would require him to subsidize those who had no insurance. Obama, he said, “did not do a very good job of explaining how all this gets paid for.” But, he added, “too much detail would have meant no bill at all.” Still, he did not vote for the state to opt out of the federal law. The state doesn’t have the right to do that, he explained. “If they want to change the law, they’ll have to go back to Congress. It’s like when they passed civil rights.”

Another university employee, assistant professor Robert Smale, knows his benefits will be reduced as a result of health reform. The university has already told him that through an e-mail sent to employees. Smale, whose speciality is Latin American history, told me that Mizzou offered one of those Cadillac plans that Congress has mandated out of existence in a few years, in an effort to keep workers who have them from going to the doctor too often. A cost-control measure for the country, the pols told us. Smale, who is thirty-seven, said that the e-mail noted that our level of benefits is too high. “Our insurance is too good, according to health care reform.”

Does that make you made? I asked. “Yes,” Smale said. “My belief is that health care is a right and that there should be basic protection offered by the government. You get up in the morning; you feel sick, you go to the doctor; you get seen quickly and you don’t pay a dime.” He was also angry at the unions for selling out their members on the Cadillac plan. When it came to the health care referendum, Smale voted against Missouri opting out of the new law, even though he doesn’t like it very much. “Barack Obama’s plan is to prop up the profitability of insurance companies and the medical industry at the expense of working people. Forcing people to buy crappy health insurance is no improvement for people.” But he voted against what he called “the crazy Republicans.”

“I disagree with them on everything,” he explained. “It was my own personal protest. I realize the insidious and backward ideology and who pushed it (the referendum) in the first place.”

Forty-six year old Karen Hayes, a community support worker, had just taken a client to the Family Health Center, which provides medical care to low income families and individuals. While she waited, she had time to chat about health care politics and her own situation. She wasn’t sure how health reform would affect her, but she did know that the coinsurance and the copays on her employer-provided coverage are killing her. Her income varies from about $27,000 to $30,000 a year, so between the $20 copay and the negotiated amount paid by her carrier, United Healthcare, she still has to come up with $50 to pay off a $150 bill. That’s hard to do sometimes, she says. “My health insurance is not adequate by any means.”

As for health reform, she says, “none of us know the total truth. It’s sketchy. In theory, I support it, but I want to see what the actual law says.” She called Missouri Sen. Claire McCaskill’s office to find out. She was referred to a website where she could read sections of the bill summarized by others, but not the actual law. “It was someone else’s interpretation. It’s all these people saying what it does say but I want to see for myself,” she said. “What might be a focus point for them might not be a focus point for me.”

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.