Mixed reaction to health care ruling

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Democrats praise, Republicans pan Supreme Court ruling; health care providers hopeful law will improve care and access

By Mike McGann, Editor, The Times
Local elected officials, political candidates and party leaders in Chester County all had varied opinions about Thursday’s U.S. Supreme Court Decision upholding the vast majority of the Affordable Care Act — President Barack Obama’s signature health care and health insurance reform program, while local health care providers expressed hope that the law would ease some of their recent struggles.

Probably not surprisingly, Democratic officials and candidates across Chester County praised the 5-4 ruling, while Republicans were universally critical.

“President Obama has just succeeded in levying the largest tax in history on middle-class Americans,” said Chester County Republican Committee chair Val DiGiorgio.  “ObamaCare not only is a government takeover on a private industry, it does so on the backs of hardworking Americans in the face of high unemployment and a weak economy.  Let’s not forget that in 2008, President Obama made a campaign promise not to raise taxes on the middle-class.  Promise Broken.“

His counterpart, Michele Vaughn, chair of the Chester County Democratic Committee praised the decision.

“This decision recognizes that healthcare reform is constitutional; it upholds years of jurisprudence and validates what President Obama embarked on as one of the most important domestic policies after passing the stimulus package,” she said in a statement. “It is a necessary response to the complicated issues that face the future health and well-being of our citizens.”

She made it clear that she felt the ruling would have a positive impact on the people of Chester county in the coming years and that November’s elections would be crucial to continuing that progress.

Meanwhile, local health care providers expressed optimism that uncertainty about the fate of the law would now end, and full implementation would improve conditions for patients and health care providers — but left worries about how and whether Medicaid changes would impact them.

“While the debate in Washington has been about the constitutionality of the individual mandate, the fact is hospitals have always had a mandate,” said Michael J. Duncan, President and CEO, of The Chester County Hospital and Health System, in a statement. “We need to take care of everybody that comes to us whether they have insurance or not.  So from a hospital standpoint this means that the people who – before – had not had any insurance – many more of them will have some kind of health insurance to pay for the services.  The way the legislation is written, it gets paid for by reducing the amount of money hospitals are paid for Medicare and Medicaid.  The two are coupled.  We will get paid less for each individual person but we’ll get paid something for most patients.”

But it remains an open question whether Pennsylvania will now participate in the newly optional Medicaid expansion — a concern for Chester County Hospital and other local health organizations.

“I’m perhaps most pleased that finally we have a ruling that the Affordable Care Act is constitutional and we can move forward to create a more efficient, higher quality health system that will cover the over 32 million Americans who have no insurance now,” said Frances Sheehan, CEO of the Brandywine Health Foundation. “The increasing cost of health care and the uncertainty around the Affordable Care Act has threatened our economic recovery – let’s move forward and make sure the law is implemented to everyone’s benefit.”

She went on to talk about the individual parts of the law that are already popular and in place, and another wave of improvements in the coming years.

“We’ve already been able to enjoy the pieces of the Affordable Care Act that large majorities agree with: young people up to 26 can stay on their parents’ plans, anyone with a pre-existing condition cannot be denied insurance, and the prescription donut hole has been closed for senior citizens,” Sheehan said.

“Now, preventive health services will be incentivized, health care providers will be rewarded for improved quality, and we can’t underestimate the benefit of enabling individuals to access affordable health insurance through the new health exchanges.”

Her concern was that Pennsylvania might opt out of the expanded Medicaid program slated to offer coverage to more low-income people.

“Now we need to turn our attention to make sure that providers like ChesPenn Health Services have the resources to serve the thousands of newly insured,” Sheehan said. “And we need to make sure that Pennsylvania doesn’t opt out of taking Medicaid funds so the law can be effectively implemented here.”

Being an election year, the decision was met with rapid reaction from those running for Congress around the county.

“Frankly, this is an extremely disappointing ruling,” said U.S. Rep. Jim Gerlach (R-6), the Republican seeking reelection in the northern portion of Chester County. “But the Supreme Court clearly did not rule that ObamaCare is a good law, just that it doesn’t violate the Constitution. Now it’s up to Congress to affirmatively go out and fix it. To do that, we’ll start by voting to repeal the law and then replace it with common-sense, market-based, patient-centered reforms that will work better to make health insurance more affordable and accessible, and relieve our job creators and taxpayers of excessive taxes and big-government regulations.”

His opponent, Democrat Manan Trivedi — a medical doctor — had a decidedly different take on the ruling.

“Today the Supreme Court made a decision that will significantly impact the health and care of all Americans,” Trivedi said. “As a nation, we recognize the importance of all citizens having access to basic healthcare, the assurance that children with pre-existing conditions will not be denied coverage and the promise that young adults can remain on their families’ health insurance policy as they becoming productive citizens in their communities and the workforce.

“As a physician, I know first-hand the stories of families fighting with insurance companies to get needed care covered and too many episodes of trying to figure out how to best care for patients who come to the ER without any coverage at all.  Hopefully this ruling will be a first step in efforts to curb those occurrences. During my career I have also seen countless examples of how the growth and significant expansion of the medical-industrial complex has made great strides in medical capabilities, but in other ways has shifted healthcare delivery to focus more on profits than patients. We must remain vigilant and remember that patients are always the first priority.

“And in the end, if we are going to truly make the Affordable Care Act affordable, we must now begin serious discussions on how to reign in healthcare costs. This is precisely why I feel it is important to have a doctor such as myself in Congress so that people with real experience in the world of providing healthcare are at the table and the best interests of patients are always represented.”

The candidates in the Seventh Congressional District showed a similar split along party lines, with the Republican saying the ruling will hit families in the pocketbook, while the Democrat praised the increase in access to health care — although both pledged to work with members of the opposite party to cut health care costs.

“With health care costs skyrocketing for families and small businesses, the health care law missed a critical opportunity to reduce the cost of care for all Americans,” U.S. Rep. Patrick Meehan (R-7), who now represents a district that curves through the middle of the county. “In fact, the President’s own actuaries said the law would increase, not decrease, national health care costs by $311 billion. The Court’s ruling does not change these facts, and I remain committed to working with Democrats and Republicans to enact real reforms to make health care more affordable for everyone without harming our economy.”

His Democratic opponent, George Badey, called the ruling a “win” for average people, but that more must be done in the coming months and years.

“The Supreme Court’s decision today to uphold the Affordable Care Act is truly a win for the American people, but it is just the beginning,” Badey said. “We still need to do more to combat rising health care costs without sacrificing quality of care. We now face the challenge of putting this legislation into action. When elected, I will reach across the aisle to enact necessary improvements to the law that will benefit all Americans. Today belongs to the millions of Americans with pre-existing conditions, who will no longer be refused or dropped from coverage, and to the millions of young people, women and seniors who can take comfort in knowing they are covered and will not be charged higher premiums due to age or gender.”

In the 16th District, the candidates expressed a similar split.

“As a mom, I am pleased to know that children with pre-existing conditions will now not run the risk of being denied coverage by the insurance industry,” said Aryanna Strader, the Democrat running for the U.S. House in the 16th District. “In addition to that, I am comforted in that we won’t again see the day where women experience the economic injustice of paying up to 150 percent more than men for an insurance policy and will have the freedom to choose their own doctors. Those who remain ardently opposed to those basic rights must continue to accept that they believe the profits of the insurance industry are more important than the equality of every American’s health.”

U.S. Rep. Joe Pitts (R-16), made it clear that he still feels strongly that the ACA is bad law, regardless of what the Supreme Court ruled this week, and would not well serve Americans.

“While I am deeply disappointed that the law was upheld, I continue to believe that it is bad policy,” Pitts said. “Just because the Supreme Court declares something Constitutional does not mean that it is a good idea. The health care law is not the reform Americans need or deserve.”

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