Dissecting the Supreme Court health care decision

By: Kara Apel Email
By: Kara Apel Email

Thursday, June 28, 2012

AUGUSTA, Ga. -- President Obama signed the Affordable Care Act in 2010. The law created health insurance reforms that are continually rolling out over time. Check out a timeline of events here.

The White House breaks down the decision:
"The Supreme Court's decision to uphold the Affordable Care Act ensures hard-working, middle class families will get the security they deserve and protects every American from the worst insurance company abuses. This law was also specifically designed to give States the resources and flexibility they need to tailor their approach to their unique needs. With the uncertainty about the Court’s decision behind us, it’s now time to focus on implementing this law in a smart and non-bureaucratic way that works for the middle class.

Benefits and Protections for the Middle Class: The Affordable Care Act includes numerous provisions to keep health care costs low, promote prevention, and hold insurance companies accountable. If you’re one of the 250 million Americans who already have health care – whether through private insurance, Medicare, or Medicaid – the Affordable Care Act is already making your coverage more secure.

Insurance companies no longer have unchecked power to cancel your policy, deny your child coverage due to a pre-existing condition, or charge women more than men.

Over 86 million Americans have gained from coverage of preventive care free of charge, like mammograms for women and wellness visits for seniors.

Nearly 13 million Americans will receive a rebate this summer because their insurance company spent too much of their premium dollars on administrative costs or CEO bonuses.

The law has already helped 5.3 million seniors and people with disabilities save an average of over $600 on prescription drugs in the “donut hole” in Medicare coverage.

The law’s provisions to strengthen and protect Medicare by fighting fraud will continue.

The law has helped 6.6 million young adults who have been able to stay on their parents’ plans until the age of 26, including 3.1 million young people who are newly insured.

If you are one of the 30 million Americans who don’t yet have health insurance, starting in 2014 this law will offer you an array of quality, affordable, private health insurance plans to choose from. If you need care, you will finally have the same opportunity to get quality, affordable coverage as everyone else.

Coverage for Americans with Pre-Existing Conditions: A major impact of the Court's decision is that 129 million people with pre-existing conditions will have the security of affordable health coverage. Starting in 2014, insurance companies can no longer charge you more, carve out benefits, or deny you coverage altogether because you have cancer or diabetes or simply because you are a woman. To make these protections affordable, people with and without pre-existing conditions should be insured, since everyone at some time needs health care.

Tax Credits for Middle Class Families and Small Businesses: Millions of Americans will soon be eligible for tax credits to ensure that their health insurance is affordable. Under today’s ruling, having health insurance is and will continue to be a choice. If you can’t afford insurance or you’re a small business that wants to provide affordable insurance to your employees, you’ll get tax credits that make coverage affordable. But starting in 2014, if you can afford insurance and you choose not to purchase it, the taxpayers will no longer subsidize your care for free. The Court’s ruling today allows Congress to hold the projected 1% of Americans who will be able to afford health insurance but will choose not to buy it responsible for that choice. Many small businesses are already receiving tax credits so they can afford to offer quality health care to their employees. To date, 360,000 businesses that employ 2 million workers have already benefitted from the small business tax cuts in the law. And once the Affordable Care Act takes full effect, about 18 million individuals and families will get tax credits for health insurance coverage averaging about $4,000 apiece.

Support for State Implementation of Affordable Insurance Exchanges: With the uncertainty of the Court decision behind us, we will step up our work with States to implement Affordable Insurance Exchanges. Exchanges are new marketplaces, starting in 2014, that will allow individuals and small businesses to compare and choose private health plans. Each State will take the lead in designing its own menu of options. Already, 34 States including the District of Columbia have received 100 percent Federally funded grants to build Exchanges. The use of Exchange grants includes support for activities related to running Exchanges in their start-up year.

States can also implement their own brand of reform through Innovation Waivers starting in 2017. If States can come up with even better ways of covering people at the same quality and low cost, this law allows them to do so. The Administration supports bipartisan legislation to allow States to start such Waivers in 2014.

Moving Forward, Not Back: No political party has a monopoly on good ideas, and the President will work with anyone to provide basic security for middle class families and end the worst insurance company abuses. But rather than refight old partisan battles by starting over on health care and repealing basic protections that provide security for the middle class, Congress needs to work together to focus on the economy and creating jobs. Right now, Congress should act on the President’s concrete plans to create an economy built to last by reducing the deficit in a balanced way and investing in education, clean energy, infrastructure, and innovation."

News 12 has compiled statements from the politicians and organizations. What do you think? Let us know in the comments. You can read more about the decision here.

President Obama:
"Good afternoon. Earlier today, the Supreme Court upheld the constitutionality of the Affordable Care Act -- the name of the health care reform we passed two years ago. In doing so, they've reaffirmed a fundamental principle that here in America -- in the wealthiest nation on Earth – no illness or accident should lead to any family’s financial ruin.

I know there will be a lot of discussion today about the politics of all this, about who won and who lost. That’s how these things tend to be viewed here in Washington. But that discussion completely misses the point. Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.

And because this law has a direct impact on so many Americans, I want to take this opportunity to talk about exactly what it means for you.

First, if you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance -- this law will only make it more secure and more affordable. Insurance companies can no longer impose lifetime limits on the amount of care you receive. They can no longer discriminate against children with preexisting conditions. They can no longer drop your coverage if you get sick. They can no longer jack up your premiums without reason. They are required to provide free preventive care like check-ups and mammograms -- a provision that's already helped 54 million Americans with private insurance. And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care.

There’s more. Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent's health care plans -- a provision that's already helped 6 million young Americans. And because of the Affordable Care Act, seniors receive a discount on their prescription drugs -- a discount that's already saved more than 5 million seniors on Medicare about $600 each.

All of this is happening because of the Affordable Care Act. These provisions provide common-sense protections for middle class families, and they enjoy broad popular support. And thanks to today’s decision, all of these benefits and protections will continue for Americans who already have health insurance.

Now, if you’re one of the 30 million Americans who don’t yet have health insurance, starting in 2014 this law will offer you an array of quality, affordable, private health insurance plans to choose from. Each state will take the lead in designing their own menu of options, and if states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too. And I’ve asked Congress to help speed up that process, and give states this flexibility in year one.

Once states set up these health insurance marketplaces, known as exchanges, insurance companies will no longer be able to discriminate against any American with a preexisting health condition. They won’t be able to charge you more just because you’re a woman. They won’t be able to bill you into bankruptcy. If you’re sick, you’ll finally have the same chance to get quality, affordable health care as everyone else. And if you can’t afford the premiums, you'll receive a credit that helps pay for it.

Today, the Supreme Court also upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance. This is important for two reasons.

First, when uninsured people who can afford coverage get sick, and show up at the emergency room for care, the rest of us end up paying for their care in the form of higher premiums.

And second, if you ask insurance companies to cover people with preexisting conditions, but don’t require people who can afford it to buy their own insurance, some folks might wait until they’re sick to buy the care they need -- which would also drive up everybody else’s premiums.

That’s why, even though I knew it wouldn’t be politically popular, and resisted the idea when I ran for this office, we ultimately included a provision in the Affordable Care Act that people who can afford to buy health insurance should take the responsibility to do so. In fact, this idea has enjoyed support from members of both parties, including the current Republican nominee for President.

Still, I know the debate over this law has been divisive. I respect the very real concerns that millions of Americans have shared. And I know a lot of coverage through this health care debate has focused on what it means politically.

Well, it should be pretty clear by now that I didn’t do this because it was good politics. I did it because I believed it was good for the country. I did it because I believed it was good for the American people.

There’s a framed letter that hangs in my office right now. It was sent to me during the health care debate by a woman named Natoma Canfield. For years and years, Natoma did everything right. She bought health insurance. She paid her premiums on time. But 18 years ago, Natoma was diagnosed with cancer. And even though she’d been cancer-free for more than a decade, her insurance company kept jacking up her rates, year after year. And despite her desire to keep her coverage -- despite her fears that she would get sick again -- she had to surrender her health insurance, and was forced to hang her fortunes on chance.

I carried Natoma’s story with me every day of the fight to pass this law. It reminded me of all the Americans, all across the country, who have had to worry not only about getting sick, but about the cost of getting well.

Natoma is well today. And because of this law, there are other Americans -- other sons and daughters, brothers and sisters, fathers and mothers -- who will not have to hang their fortunes on chance. These are the Americans for whom we passed this law.

The highest Court in the land has now spoken. We will continue to implement this law. And we'll work together to improve on it where we can. But what we won’t do -- what the country can’t afford to do -- is refight the political battles of two years ago, or go back to the way things were.

With today’s announcement, it’s time for us to move forward -- to implement and, where necessary, improve on this law. And now is the time to keep our focus on the most urgent challenge of our time: putting people back to work, paying down our debt, and building an economy where people can have confidence that if they work hard, they can get ahead.

But today, I’m as confident as ever that when we look back five years from now, or 10 years from now, or 20 years from now, we’ll be better off because we had the courage to pass this law and keep moving forward.

Thank you. God bless you, and God bless America."

The Democratic Party of Georgia:
The Affordable Care Act, or Obamacare, prevents insurance companies from denying coverage to children and adults based on pre-existing conditions and from dropping health coverage when a person gets sick. It also eliminates annual caps on health coverage for devastating illnesses and allows young adults to stay on their parents’ insurance until the age of 26.

The opinion, written by Chief Justice John Roberts- appointed by President George W. Bush- upholds every significant portion of the law.

“This is a great day for all Americans,” said Georgia Democratic Chairman Mike Berlon. “The Supreme Court rejected partisan politics and put the welfare of the people first. This decision will allow all Americans to be secure in the knowledge that if they get sick, they will have high quality and affordable health care to help them get well. It also means that children and adults will no longer be denied health care due to pre-existing conditions and young adults will be coved under their parents’ health insurance up to age 26."

Nearly 30 states, including Georgia, sued the federal government over this legislation. With the Supreme Court deciding in the Obama administration’s favor, it signifies a strong rebuke to Governor Nathan Deal’s persistent attempts to undermine health care reform.

“More than 2 million Georgians will now have access to health insurance and preventative care. We have struggled with these issues for decades and the Supreme Court got it absolutely right," said Berlon.

Ga. Gov. Nathan Deal and Attorney General Sam Olens:
Today, in the wake of the Supreme Court of the United States decision to uphold Obamacare, Gov. Nathan Deal and Attorney General Sam Olens highlighted the need for Congress to repeal the government takeover of health care, which puts crippling mandates on the taxpayers of Georgia. Georgia was one of 28 states to challenge the constitutionality of the law.

“My battle with Obamacare didn’t start when I was elected as governor of Georgia,” said DeaI. “I wear with pride my bruises and scars from the fight against its passage in the U.S. House. Today, the highest court in the country let the American people down.

“While we recognize this is a huge setback for fiscal sanity and personal liberty, we are not giving up. Georgians and the American people deserve high-quality, sustainable health care. Congress must now work steadfastly on repealing this law and replacing it with reforms that help taxpayers instead of hurt them.”

Olens said the ruling carries with it the strong implication that, contrary to the text of the Constitution and the vision of this country’s Founding Fathers, there is no longer any meaningful limit to the power of the federal government.

As Georgia's chief legal officer, Attorney General Sam Olens has led the state's legal fight against the president's health care reform law. Immediately following his swearing-in as attorney general in January 2011, Olens joined the multistate lawsuit against the law. He has steadfastly defended Georgia's interests throughout every phase of the litigation.

“I disagree with this decision. Congress explicitly said this was not a tax,” said Olens. “I call on Congress to act swiftly, repeal the law and replace it with real reform that respects the Constitution as written.”

Prior to today’s Supreme Court decision, two lower courts ruled for Georgia and its fellow plaintiffs, finding the individual mandate unconstitutional.

"Governor Deal and I are grateful to the outside lawyers who have served Georgia in this lawsuit as special assistant attorneys general at no cost to the state: Frank C. Jones, Jason Alloy, Josh Belinfante, Pitts Carr, Ben Mathis, David Oedel, John Parker, Mike Russ, and former team member and Supreme Court Justice-designate Keith Blackwell,” Olens said. “Their pro bono efforts have ensured that Georgia could participate fully in this vital lawsuit at minimal cost to taxpayers."

U.S. Sen. Jim DeMint, R-SC:
The Supreme Court may have failed to stop this government takeover of health care, but the American people will not. Since the day this law was rammed through Congress, the American people have demanded repeal, and today's ruling doesn't make Obamacare any less dangerous to our nation's health. Freedom-loving Americans are disappointed, but we cannot be discouraged.

The President's health care law must be fully repealed as all of its promises have proven false. We were told it was not a tax hike, but this ruling confirms it is an unprecedented and enormous tax on the poor and middle class Americans. President Obama needs to explain why he is enacting this middle class tax hike over the objections of the American people during the worst economic recovery since the Great Depression.

We were told it would lower health costs, but health care premiums are exploding. We were told that Americans could keep their personal health plans, but millions will now lose it. We were told it would improve our economy, but it is now the largest obstacle to employers hiring new workers.

This government takeover of health care remains as destructive, unsustainable, and unconstitutional as it was the day it was passed, unread, by a since-fired congressional majority. Now as then, our first step toward real health care reform and economic renewal remains Obamacare's full repeal, down to the last letter and punctuation mark.

I urge every governor to stop implementing the health care exchanges that would help implement the harmful effects of this misguided law. Americans have loudly rejected this federal takeover of health care, and governors should join with the people and reject its implementation.

The President's health care law will not reform anything, but is already undermining what does still work in America's health care system. We cannot build a free market health care system on this flawed structure of centralized government control, we must repeal all of it and start over with commonsense solutions that make health care more affordable and accessible for every American. We can allow Americans to purchase lower cost plans from other states, support state high-risk pools to cover those with pre-existing conditions, medical-malpractice reform to end frivolous lawsuits, and tax equity so Americans who don't get their health insurance from an employer are not penalized.

Today's decision, however unfortunate, nonetheless represents an opportunity to all Americans, to claim their right to create a health care system of, for, and by the people, not government or special interests. The American people now have the chance and Congress has the responsibility to fully repeal this Washington takeover and reform health care ourselves, together, around the principles of individual liberty, not government mandates.

The same freedom that made America strong and prosperous will make us healthier, too, so long as politicians remember that the health care system is supposed to serve our people, and not the other way around."

Ga. Sen. Hardie Davis, D-Augusta:
"I am very pleased with today's ruling. In a very short time, the PPACA has already provided many individuals with direct access to comprehensive medical services and professionals. Medicare patients are now paying less for necessary prescriptions, and approximately 3.1 million young adults have gained coverage through the 26 and under mandate.

The United States is one of the wealthiest and most powerful nations in the world, and we are often considered "the leader of the free world." The United States now has the framework for a reformed health care system that brings us in line with other leading countries and provides our citizens with a greatly needed benefit. In Georgia alone, the Supreme Court ruling will positively impact nearly two million people who are currently without health insurance.

We are no longer at the mercy of insurance companies whose ultimate goal is to turn a profit instead of helping sick individuals and families. Our federal government has a responsibility to provide a high quality of life for its citizens, and the PPACA will ensure that everyone, from the very young to the very old, will be able to receive both preventative services and catastrophic care. No one should have to live a life of chronic sickness or poor health simply because he or she cannot afford a doctor's visit. I commend those who have worked tirelessly to put health care within reach of every Georgian."

U.S. Sen. Lindsey Graham, R-SC:
"To our Democratic colleagues, stand by your tax increase or stand with us to Repeal and Replace Obamacare. During the entire congressional debate over Obamcare, Democrats vehemently denied this was a tax on the American people. The Obama Administration also denied it was a tax. However, when the case went to Court, they argued, for constitutional purposes, it was a tax.

I have always believed the individual mandate would not be upheld under the Commerce Clause because you cannot compel someone to enter into commerce. However, I have always been afraid the broad power to tax could be used by the Court to justify Obamacare. The problem for the American people is this is a massive tax increase at a time they can least afford it and Obamacare will jeopardize the quality and accessibility of health care.

Now Congress has a chance to Repeal and Replace Obamacare, one of the largest tax increases on the American people, with common-sense health care reform we can afford. I am glad I voted against one of the largest tax increases on the American people in modern history for the purpose of creating government-controlled health care.

The question for Congress is -- Did you intend to tax the American people by hundreds of billions of dollars to create a government-controlled health care system or not?

I am urging the Republican leadership to immediately insist on debating whether or not Obamacare is in fact a tax in the eyes of the politicians who proposed the legislation. If it was never meant to be a tax, they should immediately Repeal and Replace this bill."

U.S. Rep. Paul Broun, R-Ga.:
"Today is a sad day for liberty. The Court's misguided decision is an attack on freedom, an insult to our Constitution, and it will ultimately destroy the best healthcare system in the world. Chief Justice Roberts once said that the Supreme Court's job is to apply the law - 'to call balls and strikes, not to pitch or bat.' He couldn't have been more right in saying so, and he couldn't have been more wrong by choosing to circumvent the Constitution this morning. Even worse, I fear that the High Court has opened Pandora's box by blatantly disregarding the law, and there will no longer be any real limits to what the federal government will be able to force the American people to do.

President Obama and Democrats in Congress promised the American people that their healthcare law wouldn't raise taxes. They lied. Today the Supreme Court defined Obamacare as exactly that - a tax increase on every man, woman, and child in the United States.

As a physician, I can tell you that if Obamacare takes full effect - patients won't be able to afford health insurance, medical practices will be controlled by the government, employers will stop providing coverage for their workers, and Medicare and Medicaid recipients will be left high and dry. That's why despite the Court's liberal ruling, I will continue working to completely repeal Obamacare.

It's true that our healthcare system is in dire need of reform, but President Obama's idea of putting everyone in one pool and handing it over to the federal government is not the way to fix it. More than fifty percent of Americans think that members of Congress who are doctors and nurses should write new healthcare legislation, and that's exactly what I've been working on in Washington. In just 51 pages, my OPTION Act will make healthcare cheaper for everyone, provide coverage for all Americans, and save Medicare from going broke. This replacement bill gives the people back their right to make their own healthcare decisions, and I will continue to work tirelessly on behalf of Georgians and all Americans until something like it passes."

Georgia Chamber of Commerce President and CEO Chris Clark:
"We are greatly disappointed in the decision rendered today by the Supreme Court and believe that the path on which our nation is being forced to move forward will be detrimental to both employers and employees throughout the nation as a result of increased costs and new regulations. Businesses will be forced to make difficult decisions that will likely result in employees losing their employer-provided coverage. Our organization will look forward to working with the Governor and other leaders at the state and federal level to implement the law in a way that takes into account the important role businesses play by providing this important benefit and the overall impact on our economy."

Georgia Health Sciences Medical Center CEO David S. Hefner:
"As the state’s academic health center and a leading provider of specialized care, we provide approximately $100 million in uncompensated care and community benefit to the citizens of Georgia. Today’s ruling by the U.S. Supreme Court, upholding most of the Affordable Care Act, will give 32 million people who are currently uninsured access to care they’ve never had. We are committed to helping them gain that access in the most seamless way possible. This decision by the courts allows us to move forward so that we can continue with the business of providing quality healthcare to Georgia and the Southeast.

It is important to note, however, that with this increase of people seeking health care, the impending physician shortage will become a quick reality. Without funding for graduate medical education, we simply will not be able to produce enough doctors for the state of Georgia, which is the 9th fastest growing state in the country, but ranks 41st in physicians per capita.”

U.S. Rep. John Barrow, D-Ga.:
“This health care legislation was flawed from the beginning, which is why I voted against this law in committee and twice on the House floor. For the most part, the Supreme Court has ruled that the law doesn't violate the Constitution, but that won't fix the problems the law doesn't solve, and it won't fix the problems the law actually makes worse. We have to cut spending and cut health costs, but its starts with rejecting the false choice being offered by both parties, that it's all or nothing."

U.S. Sen. Saxby Chambliss, R-Ga.:
“I am disappointed in today’s decision. While I believe the individual mandate to directly contradict the Constitution, we must respect the decision of the Supreme Court. However, this is not the final chapter in the healthcare-reform debate. I will continue to push to repeal the law, and urge Congress and the next administration to work to replace Obamacare.

This law adds new taxes on an already overtaxed population, and adds regulation to an already over-regulated industry. We must address the skyrocketing costs of health care and its impact on individuals, families and small businesses while working together on transparent and measured reforms to ensure that everyone has access to quality and affordable care.”


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