Supreme Court re­jects se­ri­ous threat to health re­form

Los Angeles Times - - FRONT PAGE - By Noam N. Levey

WASH­ING­TON — The Af­ford­able Care Act, up­held in a de­ci­sive 6- 3 Supreme Court rul­ing Thurs­day, is now vir­tu­ally as­sured of sur­viv­ing as a per­ma­nent fea­ture of the Amer­i­can health­care sys­tem.

Re­pub­li­cans’ chances of re­peal­ing the law, which pro­vides health coverage to more than 20 mil­lion Amer­i­cans, all but evap­o­rated af­ter the strongly worded de­ci­sion writ­ten by Chief Justice John G. Roberts Jr.

It was the sec­ond time in three years that the high court had turned aside a le­gal threat to the law, one of Pres­i­dent Obama’s sig­na­ture achieve­ments.

With no se­ri­ous Repub­li­can al­ter­na­tives and a his­toric ex­pan­sion in med­i­cal coverage well un­der­way, Oba­macare is about as firmly en­sconced as a new law can be in a po­lit­i­cally di­vided coun­try.

The rul­ing came in a law­suit that had threat­ened to strip in­surance sub­si­dies from more than 6 mil­lion Amer­i­cans in at least 34 states.

The law’s word­ing was at times “inart­ful,” the ma­jor­ity said, but Congress clearly in­tended for the aid for low- and mod­er­ate- in­come Amer­i­cans to be avail­able ev­ery­where. The jus­tices re­jected claims from the chal­lengers that a hand­ful of words in the statute made sub­si­dies avail­able only in a few states.

“We must read the words in their con­text,” the chief justice wrote.

In the de­ci­sion, Roberts also ex­plic­itly blessed the law’s sweep­ing sys­tem for guar­an­tee­ing coverage, not­ing that the model, pi­o­neered in Mas­sachusetts, had ac­com­plished what

other at­tempts to ex­tend in­surance pro­tec­tions to Amer­i­cans had not.

“The Af­ford­able Care Act adopts a ver­sion of the … re­forms that made the Mas­sachusetts sys­tem a suc­cess,” he wrote.

Con­gres­sional Re­pub­li­cans, mean­while, still have no plan to re­place the law en­acted more than f ive years ago.

Speak­ing to re­porters af­ter the court’s de­ci­sion, House Speaker John A. Boehner ( R- Ohio) re­peat­edly re­fused to com­mit to any new strat­egy to re­peal or re­vise the health law.

And across the coun­try, as mil­lions of pre­vi­ously unin­sured Amer­i­cans have gained coverage, a grow­ing num­ber of Repub­li­can gov­er­nors are sig­nal­ing their in­ter­est in mov­ing on.

Still, political bat­tles over the law won’t end any­time soon.

In the pres­i­den­tial cam­paign, Repub­li­can hope­fuls need to ap­peal to con­ser­va­tive vot­ers — many of whom deeply dis­like the law and the pres­i­dent who cham­pi­oned it. That guar­an­tees that cries for re­peal will re­main prom­i­nent, par­tic­u­larly dur­ing next year’s pri­maries.

“This is not the end of the f ight,” for­mer Florida Gov. Jeb Bush said Thurs­day. “We need to re­peal and re­place Oba­macare.”

Nearly all of the other ma­jor can­di­dates for the nom­i­na­tion echoed Bush’s state­ment.

But away from the cam­paign trail, im­ple­men­ta­tion of the law and its coverage ex­pan­sion will con­tinue.

“We ap­pre­ci­ate that the deep un­cer­tainty of this is­sue has been re­solved,” Michi­gan Gov. Rick Sny­der, a Repub­li­can, said Thurs­day af­ter the court is­sued its de­ci­sion. “The health and well- be­ing of the peo­ple of Michi­gan is al­ways a top pri­or­ity.”

In his state, more than 200,000 low- and mod­er­atein­come res­i­dents stood to lose in­surance as­sis­tance if the court backed the chal­lengers, who ar­gued that no sub­si­dies should be avail­able in any state that did not es­tab­lish its own in­surance mar­ket­place through the law.

Michi­gan is one of the 34 states that in­stead de­ferred to the fed­eral Health­Care . gov mar­ket­place.

Like many other Repub­li­can gov­er­nors, Sny­der has been more fo­cused on ex­pand­ing ac­cess to health­care than con­tin­u­ing the bat­tle over the law.

Michi­gan is work­ing to se­cure ap­proval from the Obama ad­min­is­tra­tion for fur­ther changes to the state’s Med­i­caid pro­gram, which was ex­panded un­der the law to guar­an­tee coverage to the poor­est resi- dents.

Michi­gan is one of 29 states that have ac­cepted fed­eral aid in the law to broaden Med­i­caid coverage — a num­ber that has steadily grown over the last sev­eral years to in­clude even very con­ser­va­tive states such as In­di­ana.

In the last two years, some 11 mil­lion peo­ple have newly en­rolled in Med­i­caid, mostly in states that ex­panded their pro­grams.

An ad­di­tional 10 mil­lion Amer­i­cans, many of them pre­vi­ously unin­sured, now get health coverage through mar­ket­places cre­ated by the law.

That has fu­eled a his­toric coverage ex­pan­sion. In the f irst quar­ter of this year, 11.9% of adults in the U. S. lacked in­surance, down from 18% in the third quar­ter of 2013, be­fore the cur­rent ex­pan­sion be­gan, ac­cord­ing to Gallup.

And more red states, in­clud­ing Utah, Ten­nessee and Wy­oming, have been ex­plor­ing ways to ex­pand Med­i­caid coverage.

In Wash­ing­ton, by con­trast, GOP con­gres­sional lead­ers kept up their crit­i­cism of the law.

“Re­pub­li­cans are ready to re­duce the cost of health­care so more peo­ple can af­ford it, put pa­tients back in charge, and re­store free­dom and choice to the health­care mar­ket,” said Se­nate Health Com­mit­tee Chair­man La­mar Alexan­der ( RTenn.).

But it is un­likely there will be sig­nif­i­cant new leg­is­la­tion, at least un­til af­ter next year’s pres­i­den­tial elec­tion.

To date, Alexan­der and most other con­gres­sional Re­pub­li­cans have of­fered lit­tle more than gen­eral out­lines rather than real leg­is­la­tion that would ful­fill such prom­ises.

Sev­eral GOP blue­prints even in­cor­po­rate key pro­tec­tions from the cur­rent law, in­clud­ing guar­an­tee­ing coverage and pro­vid­ing govern­ment as­sis­tance to help con­sumers pur­chase in­surance.

On the other side of the debate, sup­port­ers of the health law re­dou­bled their calls on Re­pub­li­cans to stop fight­ing.

“It’s time for peo­ple on both sides of the aisle to ac­cept that the law is work­ing and take im­por­tant steps to fully im­ple­ment it,” said Sue Berkowitz, head of South Carolina Ap­ple­seed Le­gal Justice Cen­ter, a non­profit that has been work­ing to ex­pand coverage in that state de­spite Repub­li­can of­fi­cials’ re­sis­tance to Med­i­caid ex­pan­sion.

The pres­i­dent joined the cho­rus, speak­ing from the White House Rose Gar­den on Thurs­day af­ter­noon.

“The Af­ford­able Care Act is here to stay,” he said.

‘ We ap­pre­ci­ate that the deep un­cer­tainty of this is­sue has been re­solved. The health and well- be­ing of the peo­ple of Michi­gan is al­ways a top pri­or­ity.’

— RICK SNY­DER, Michi­gan’s Repub­li­can gover­nor

Ji m Lo Scalzo Euro­pean Pressphoto Agency

SUP­PORT­ERS of the Af­ford­able Care Act cheer out­side the Supreme Court af­ter jus­tices ruled 6 to 3 that the health­care law’s tax cred­its can go to res­i­dents of any state.

Alex Wong Getty I mages

“THE AF­FORD­ABLE Care Act is here to stay,” said Pres­i­dent Obama, with Vice Pres­i­dent Bi­den at the White House Rose Gar­den af­ter the rul­ing was an­nounced.



Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.