Is Court's Health-Care Ruling a Wise Decision? It Depends...

THURSDAY June 28, 2012 -- Supporters of the Obama administration's health care reform law said Thursday that the U.S. Supreme Court's decision upholding the landmark legislation protects the health of millions of Americans, but critics claim it does so at the expense of key civil liberties and exacts a high economic toll.

The 5-to-4 ruling "means millions of Americans can look forward to the coverage they need to get healthy and stay healthy," Dr. Jeremy Lazarus, president of the American Medical Association, said in a statement.

"This decision protects important improvements, such as ending coverage denials due to preexisting conditions and lifetime caps on insurance, and allowing the 2.5 million young adults up to age 26 who gained coverage under the law to stay on their parents' health insurance policies," Lazarus said.

Already, about 54 million Americans are benefiting from expanded preventive and wellness care coverage, Lazarus noted.

But many of those who oppose the legislation fear the federal government is intruding into the lives of private citizens.

"I'm disappointed that the Court is willing to give the federal government the power to tell you what has to be in your health care plan down to your contraceptives and mammograms," said John Goodman, president and founder of the National Center for Policy Analysis. "That's a great deal of power."

Economically, the Affordable Care Act "is one reason economic recovery has been so anemic," he suggested. Although hours worked across the United States are now what they were before the recession, hiring is not at pre-recession levels, he said, attributing that lag to "Obamacare" insurance requirements.

"The mandates come with a big price tag for employers and employees," Goodman said. The cost of family coverage works out to $6 an hour, he added.

Whether for or against the law, experts voiced relief that a decision was reached.

"We're very relieved and eager to move forward from here now that we have some certainty," said Dr. Glen Stream, president of the American Academy of Family Physicians.

The law's comprehensive primary-care initiative ensures funding for important health practices related to the "medical home" approach, he said. Preventive services, such as wellness coaching, dietitians and electronic record-keeping programs, are now accessible to many Americans through public and private payers, he noted.

Another benefit, according to Stream, is the provision for primary care work-force training. "Federally qualified community health centers have the capacity to train family physicians, which is critical," he said.

"Now we can work on other meaningful reforms," he said, mentioning liability reform.

Alison Renner Manson, manager of government affairs and policy for the National Coalition on Health Care, predicted that Congress has some hard work ahead. In some ways, the ruling was only the tip of the iceberg, she noted.

"The decision upholds existing law, so we're not looking at major changes," she said. "A lot of decisions on health care need to be made over the next year that will have a larger impact."

For instance, even with the Affordable Care Act in place, as much as one-third of U.S. health spending benefits no one's health, Manson said.

"It's an ongoing problem we have to deal with one way or another," she said. These issues include unnecessary or duplicated tests and services, excessive administrative costs, and instances of fraud and abuse, she explained. "We want to get more for our health-care dollars, but we don't want people to go without services," she said. And for that to happen, consumers, politicians and policy makers will have to work together, her group believes.

Because the court decision upheld the individual mandate of the Affordable Care Act under a constitutional tax provision, there could be surprise financial implications, some say.

Karen Ignagni, president and CEO of America's Health Insurance Plans (AHIP), said in a statement that she anticipates financial obstacles as a result of the ruling. AHIP is a Washington, D.C.-based trade association representing the health insurance industry.

"The law expands coverage to millions of Americans, a goal health plans have long supported, but major provisions, such as the premium tax, will have the unintended consequences of raising costs and disrupting coverage unless they are addressed," she noted.

"Health plans will continue to work with policymakers on both sides of the aisle to make coverage more affordable, give families and employers peace of mind, and promote choice and competition," she said.

Figures reviewed by AHIP indicate that the minimum essential health benefits requirement "will result in less affordable coverage for individuals, families and small employers by forcing them to 'buy up' and purchase more coverage than they may want or need," she added.

More information

To learn more about a medical home, see the American College of Physicians.

Posted: June 2012


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