Supreme Court Agrees to Hear Health Care Reform Challenges, But Health Care Reform Already Fundamentally Changing the Health Care and Health Insurance Industries

Although the Supreme Court has agreed to hear challenges to health care reform, the debate is unlikely to be settled by the high court's decision, and the landscape of health care and health care insurance is already undergoing major and lasting changes.
As reported by a number of news outlets, the United States Supreme Court has indicated that it will hear legal challenges to the Obama administration's health care reform initiatives, which were set forth primarily in the Patient Protection and Affordable Care Act of 2010 and related legislation ("PPACA"). Arguments before the Supreme Court justices in the health care reform matter are scheduled for March of 2012.
The justices announced they will hear an extraordinary five-and-a-half hours of arguments from lawyers on the constitutionality of a provision at the heart of the law and three other related questions about the act.[1]
PPACA includes a number of different reforms relative to the health insurance industry as well as public health programs with the stated goal of increasing individual health insurance coverage while decreasing health care and health insurance costs.

The law's "individual mandate" is a principal point of contention.
A number of states and other parties have filed challenges to PPACA, with one of the principal points of contention being the so-called "individual mandate" under PPACA that legally requires individuals to obtain a minimum level of health insurance coverage. However, other issues will also be before the Supreme Court when it hears the matter in March.
The questions the Supreme Court asked lawyers to argue when the justices consider appeals of President Barack Obama’s health care overhaul in March:
  • Does Congress have the power to mandate that Americans buy health insurance or pay a penalty?
  • If the requirement to buy insurance is unconstitutional, is the whole law unconstitutional? What other parts of the law, if any, could survive?
  • Is Congress illegally coercing states to expand Medicaid, the subsidized health care for the poor and disabled, by threatening to withhold funding from states that refuse?
  • Since the penalty for not buying health insurance doesn’t go into effect until federal income taxes are due in 2015, are legal arguments currently brought against the health care overhaul premature?[2]
Observers are predicting a Supreme Court decision on President Obama's health care reform sometime next summer, just before the November presidential election. As such, health care reform is expected to become a major political issue in the presidential race.

The Supreme Court's decision on the constitutionality of the individual mandate is unlikely to finally settle the matter.
However, both sides of the argument agree that the Supreme Court's decision on PPACA and the constitutionality of the individual mandate is unlikely to finally settle the matter. Opponents of the health care reform initiatives say that, even if the Supreme Court upholds the individual mandate and other matters at issue, they will continue to challenge other provisions and seek repeal of the Obama administration's health care reform legislation in Congress.

But if the Supreme Court strikes down the individual mandate as unconstitutional, proponents have indicated their commitment to continue pressing forward with the rest of Obama's health care reform agenda.[3]

The health insurance industry has already begun to change because of these initiatives and other forces.
Additionally, the health insurance industry has already begun to shift as a result of legislative initiatives such as PPACA and other forces, including economic pressures and consumer demands. Consider the following from a recent New York Times article suggesting that health care in the United States is inexorably changing, despite the legal uncertainties:
No matter what the Supreme Court decides about the constitutionality of the federal law adopted last year, health care in America has changed in ways that will not be easily undone. Provisions already put in place, like tougher oversight of health insurers, the expansion of coverage to one million young adults and more protections for workers with pre-existing conditions are already well cemented and popular.
From Colorado to Maryland, hospitals are scrambling to buy hospitals. Doctors are leaving small private practices. Large insurance companies are becoming more dominant as smaller ones disappear because they cannot stay competitive. States are simplifying decades of Medicaid rules and planning new ways for poor and rich alike to buy policies more easily.
Other changes influenced by the legislation may leave some patients and doctors lost in the new land of giants. As medicine moves from a cottage industry to one dominated by large organizations, some patients with insurance will probably find their choices more limited. But their care may be better coordinated, as hospitals, doctors and even insurers join to streamline services.
Even if the Supreme Court upholds the law’s requirement for many employers to offer coverage to workers, it is not clear that Congress will want to keep the requirement in its current form or see it vigorously enforced. With the nation’s unemployment rate stubbornly stuck around 9 percent, businesses often cite the costs of providing health care coverage as one of the reasons they cannot hire or expand their work force.
Despite opposition in some corners and lukewarm reception in others, a wholesale repeal of the law by Congress may be unlikely. Lawmakers may find it unpalatable to abandon the entire effort, given the fact that critics of the law have not agreed on one comprehensive proposal that would offer coverage to anywhere near the 50 million Americans who are still without coverage. Even if the law goes into effect, an estimated 20 million will still be without insurance. [4]


1Supreme Court Will Hear Health Care Case This Term, Jesse J. Holland and Mark Sherman, Associated Press, Business Week, November 14, 2011.
2A Quick Look At The 4 Questions At Issue In The Supreme Court’s Health Care Overhaul, Associated Press, November 15, 2011.
3Justices Unlikely To Have Last Word On Health Care, Ricardo Alonso-Zaldivar, Associated Press, November 15, 2011.
4Whatever Court Rules, Major Changes in Health Care Likely to Last, Reed Abelson, Gardiner Harris and Robert Pear, New York Times, November 14, 2011.

1 comment:

  1. Health insurance is the way to go, since you wouldn't know when your going to be sick. Thanks.

    ReplyDelete