Local experts: Questions about health law remain until Nov. elections

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June 29, 2012

Local experts: Questions about health law remain until Nov. elections

By Denise Richardson Staff Writer The Daily Star Fri Jun 29, 2012, 03:30 AM EDT

The Supreme Court's decision backing the Affordable Care Act is an important step in efforts to provide health care for all Americans, some local sources said Thursday.

"It's a big deal," said William Wilkerson, an associate professor and chairman of the political science department at the State University College at Oneonta. "For now, it upholds the law and allows Obamacare to move forward."

But some questions linger about its further implementation and effectiveness -- and about reaction at the ballot box in November.

Republicans already were energized in opposition to the Affordable Care Act before the court's ruling Thursday, Wilkerson said, and the high court's decision is likely to spark Democrats on the political front.

The court's decision leaves the future of law up to American democracy and elections, he said.

In the 5-4 decision, Chief Justice John Roberts rejected the administration's claim that Congress had the power under the Constitution's commerce clause to put the mandate in place, The Associated Press reported.

Wilkerson, who described the court decision as "humble" without heavy criticism, said Roberts reviewed possibilities of the commerce question and settled on the position that Congress is within its power to impose a penalty, or tax. To have designated it a commerce clause would result in more precedents and broader areas of regulation, Wilkerson said.

President Barack Obama's historic health overhaul carried a core requirement that nearly every American have health insurance.

The Affordable Care Act could well have been the best law possible at the time it was approved, said Karl Seeley, associate professor of economics at Hartwick College in Oneonta. But the act is weak on insurance reform, leaving inefficiencies in place, he said.

The United States spends a lot of money on health care with poor results in part because of expenses for overhead, Seeley said. Questions about health care costs will intensify, he said, and unemployment and recession factors will intensify the debate.

If health care cost problems could be solved, specifically those involving Medicare and Medicaid, the future costs and deficits of government would be reduced, according to Seeley, who had a mixed reaction to the Supreme Court decision.

'I'm conflicted," Seeley said. "It's better to hold up a lame improvement than to go back to worse."

Barbara Ann Heegan, executive director of the Otsego County Chamber, said health care costs are a "tremendous burden on large and small employers." The Supreme Court court's decision emphasizes "the importance of health care costs and utilization" in New York state, which has one of the most expensive health insurance markets in the nation, she said in a prepared statement.

Policymakers and the business community need to work together to promote wellness, quality, control costs and improve access, Heegan said. Businesses must be informed, a task that calls for cooperation among businesses, individuals, institutions and governments, she said.

Dr. William F. Streck, president and chief executive officer of the Bassett Healthcare Network in Cooperstown, said in a statement that the Supreme Court decision is important to "a broad cross-section of America, particularly the millions who are uninsured or underinsured."

"With the law now affirmed, progress will continue, driven not just by the law but by the recognition that a more efficient and less costly health system is necessary for the country," Streck said. "The evolution of the Bassett Healthcare Network has been consistent with the goal of adequate access to quality, affordable health care and the affirmation of the law will support that commitment."

Hospitals nationwide already had agreed to $155 billion in Medicare cuts during a 10-year period as part of the bill, Streck said, and bringing the uninsured into the ranks of the insured was intended to help offset these Medicare cuts.

Planned Parenthood of South Central New York applauded the Supreme Court decision in a media release issued Thursday.

"The ruling by the Supreme Court upholding the Affordable Care Act means that health care, including birth control, for the women of New York and the nation will be more affordable and accessible," said Debra Marcus, chief executive officer of Planned Parenthood of South Central New York.

In particular, under the decision, women will have access to birth control without co-pays starting in August, saving up to $600 annually year, said the release from the South Central group, which has clinics in Oneonta, Sidney, Walton and Norwich.

According to the Kaiser Foundation, more than a million New York women ages 18 to 64 were uninsured between 2008 and 2009, the Planned Parenthood release said, and under the Affordable Care Act, nearly half of those women could be eligible for Medicaid in 2014 and another 40 percent may be eligible for subsidies to purchase insurance through New York's health exchange.

"Women and families should never have to choose between affording life-saving health care and feeding their families," Marcus said. "With the Affordable Care Act now affirmed, everyone can have health insurance."