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What Does Obamacare Ruling Mean for Pa.?

Keystone state lawmakers say Supreme Court ruling on health care is "unfortunate"

By Melissa Daniels | PA Independent

HARRISBURG — Requiring individuals to purchase health care is constitutional.

Withholding extensive federal funding from states as punishment is not constitutional.

Also: paying a tax for not buying health insurance is constitutional.

On Thursday, the U.S. Supreme Court upheld the major components Patient Protection and Affordable Care Act that includes the controversial individual mandate on the grounds that Congress has powers to levy taxes and fees.

The decision was 5-4, with Chief Justice John Roberts siding with the majority.

Upholding the act will give hundreds of thousands of Pennsylvanians access to health care, whether through an individually purchased policy or through a Medicaid expansion.

Already, millions of Pennsylvanians have received benefits under the act, from some 235,000 elderly Medicare beneficiaries who received prescription discounts to 1.5 million Pennsylvanians who received at least one preventative care treatment.

Around 4,500 Pennsylvanians now have access to health care who were previously denied for pre-existing conditions.

Keystone Progress, a Pennsylvania-based coalition of unions and progressive groups, called the decision a victory, and a leap towards achieving equitable health care across society.

“This decision will ensure that children with pre-existing health conditions will have the care they need, young adults will be able to stay on their parents’ health plans, small businesses will receive tax health insurance credits, thousands of Pennsylvanians will get rebates from their insurers this summer, and millions will no longer have out-of-pocket costs for routine preventive care,” said Keystone Progress Executive Director Michael Morrill in a statement.

Now Pennsylvania agencies, and the health care industry, will have new systems to implement to comply with the legislation. That includes the state using  a $30 million federal grant to help fund the establishment of an online health insurance marketplace, or exchange, ready for use at the start of 2014.

Speaking the night before the decision, Gov. Tom Corbett, said he was confident the Insurance Department was prepared to move forward with establishing the exchange if the act was upheld.

One of the most contentious questions in the decision was if an individual could be penalized for not purchasing health insurance. That piece was upheld and interpreted as a tax.

Moving forward, someone who decides to not purchase health insurance will face an incrementally increasing individual penalty of 2.5 percent of annual income by 2016 .

“Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax. This is sufficient to sustain it,” stated the majority opinion in a more than 190-page decision.

The decision is a major victory for President Barack Obama, his supporters and the Democratic party. Given that, the partisan divide on the ACA decision is already evident:

State Rep. Greg Vitali, D-Delaware, said he wasn’t surprised by the ruling, comparing health insurance to auto insurance.

“It’s the same situation.  If you don’t have it, other people have to pay for you, so I think it makes sense,” he said.

On the other side of the aisle, state Rep. Matt Gabler, R-Clearfield, said the ruling was “certainly unfortunate” and predicted it would become a central issue of the upcoming national election.

“I think it really underscores the importance of the upcoming election,” he said. “Americans will have to decide for themselves if this is the direction they want the country to go.”

In the dissenting opinion, Justice Anthony Kennedy called the legislation “invalid in its entirety.”

Some changes brought on by the act are already evident. Estimates from the House Appropriations Committee say around 65,000 Pennsylvanians under 26 have insurance as part of the act than extends benefits for dependents.

Pennsylvania has its own state law that allows people up to age 29 to have insurance with several exceptions. According to the National Conference of State Legislatures, states may continue to apply their own laws for dependent insurance to the extent that they don’t preclude federal laws.

While the expansions may seem constitutional, the majority did address one facet of Congressional control. The states who filed the case, including Pennsylvania under then-attorney general Corbett, argued the federal government could not coerce states to expand Medicaid by withholding federal funds as a penalty for opting out.

But the high court’s interpretation says the federal government cannot punish states for opting out by withholding all Medicaid dollars.

“What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding,” according to Robert’s majority decision.

State Rep. Stephen Bloom, R-Cumberland, said the Medicaid provisions in the ruling were important for Pennsylvania taxpayers because it would leave the state in control of its own fate in that regard.

“It means we will not be forced to expand the state’s Medicaid system beyond the truly needy,” he said

Many across the nation opposed the act on the grounds that Congress did not have the right to tell states what do with their health care programs. Tarren Bragdon, chief executive officer of Florida-based think tank Foundation for Government accountability, said what works in one state may not work in another, given how different the states really are.

Given that, ACA may not be the sole savior of the health care system, he said.

“Regardless of what the Supreme Court rules, our health care challenges will not go away,” said Bragdon, speaking several weeks prior to the decision. “Just as the problems are not partisan, neither are the solutions and the states have proven there are tested, proven bipartisan solutions to address the biggest needs in health care.”

Bureau Chief Eric Boehm contributed to this report

Keith July 05, 2012 at 01:25 AM
As we celebrate our independence, let us not forget about the tyranny of the King of Britain (1776) . And our forefathers who took up arms and refused to be held under the thumb of that tyrant! The past tends to repeat itself. Taxation is what caused our rebellion and independence! HAPPY ID4!
Guy Ramsey July 05, 2012 at 09:31 AM
I was pleased by the court's ruling. The president had it right. The time had come for the elected officials in our govenrment to step in. The corporate interests, medical manufacturers, drug companies, care providers, and insurance companies were not able to provide appropriate access to affordable healthcare. Greed had corrupted the market. Many of the loudest voices opposing the legislation are those the changes are driven to protect the weath machine they created. They are not interested in seeing a system that provides access to the poor or those afflicted with chronic disease. The broad provisions of the act are reasonable. There will be adjustments to fix inequities created by the sweeping changes in the act.
Peter July 05, 2012 at 11:48 AM
i don't have a problem with providing affordable healthcare...my problem is with the use of the term "Affordable Healthcare Act" to implement processes and provisions that are unnecessary and detrimental. there's too much un-known and too many allies of the administration that have opt-ed out. Why not have a smaller bill that deals with pre-exisitng conditions and coverage caps? why 200 pages? people will blame capitalism and free market for the problems in healthcare...but the previous system was far from a capitalistic system. i go to work for a company, they tell me who the insurance company is, and i get to pick from 3 sh!tty plans? where is the free market? if the government or companies want to provide healthcare as a benefit, the provide a basic, catastrophic coverage. if people want a wellness plan on top of that, let them shop from providers. my other issue with the whole thing is the deception used to gain support for it. the whole "tax" thing, telling people that they can keep their plan, etc. the liberals in office love to think they their intellect is far superior to that of the masses...unfortunately it seems they're correct judging from how people couldn't see thru the bs. the administration has no intention of letting you keep your insurance...everything is constructed to force people over to the exchanges. Look what they just did with TRICARE (insurance for service members). they jacked the rates hoping they'll switch to the exchanges.
Blackdemon July 05, 2012 at 12:31 PM
I am one of the people who is paying for healthcare, and can not go because of the cost of seeing my Doctor. I take my son, and pay the price. My Doctor calls, and wants me to have tests done because I am over Fifty. I told him I can't afford it, even though I pay for Healthcare every week out of my paycheck. My HR Dept. already told me that in 2014 when the new laws take effect, I lose my Healthcare. It is cheaper for them to pay the fine, and make us go into the system. They don't feel guilty, because we will be forced to have Healthcare through the Govt. In other words I still won't be able to go to the Doctor.
SWT Resident July 05, 2012 at 12:46 PM
Blackdemon....this is exactly what will happen all across the valley for companies with 50 or less full time employers: they will cancel the health care for their employees and pay the fine. It is cheaper and less of a yearly hassle when someone in the company has to take the time and review cost increases every year, do all the paperwork, etc. It is the chicken-shyt way out especially for many loyal employees for those companies who have been the driving force behind the success for the company. Our owner already told us his intentions. Plus...when we have to purchase our own insurance...we won't see a nickle in salary compensation more towards paying the cost of our own plans. That really is a fine how do you do. We'll see what happens after 2014. Obama awoke a sleeping dragon and it will bankrupt America by 2025 OR the 'death squads' will be working over time with their 'NO' stamper. I hope those that supported this ACA Health Care Reform take off their rose colored glasses and see who really wins: our elected officials who STILL will have their premium plan. If this ACA Plan was or will be so good...why did 99% of our elected officials vote NO when asked to join?
Tony July 05, 2012 at 01:27 PM
They voted 'No" when asked to join, because the republicans and democrats want US to continue to pay for their healthcare. It's free, why would they want to not get Free healthcare. lol. ohhhhhh those politicians....The other side of the story is Romney is 100% for nationwide healthcare...that is fact...so what is the other answer...
Elyssia Mathias July 05, 2012 at 05:16 PM
"Upholding the act will give hundreds of thousands of Pennsylvanians access to health care, whether through an individually purchased policy or through a Medicaid expansion." Excuse me, but I believe you mean, access to health insurance. Anyone who goes to an emergency room has to be treated, regardless of their ability to pay for the care they receive. Physicians and hospitals: the new indentured servants.
Rosemary B July 05, 2012 at 07:01 PM
http://www.youtube.com/watch?v=UDrdUgZFnRk&feature=youtu.be A woman's experience with England's socialized healthcare system and what she fears will happen here.
Tony July 05, 2012 at 07:38 PM
another video about the current system: http://www.youtube.com/watch?v=Rw_dS330i34
Rosemary B July 06, 2012 at 12:24 AM
http://www.youtube.com/watch?feature=endscreen&v=7XsRzfckneg&NR=1 About how wonderful the healthcare is in Canada and England.
Guy Ramsey July 06, 2012 at 02:09 AM
Interesting perspective. So, you propose something much closer to how we buy car insurance. You have to buy it. Your employer has nothing to do with it. Thought provoking. My employer does provide coverage. I pay a little more than half. If I got the money, and the insurance companies had rules to live by, It might work. It might work, there are a lot of unknowns. Because our health coverage has evolved, under pressure from unions, as a part of a benefit package. If we moved to this paradigm . . . It would be more competative.
Patriot2 July 06, 2012 at 02:48 PM
There is some confusion in some comments made above. Companies with less than 50 full time employees do not have to provide health care insurance and will not pay fines. That is the burden for companies of over 50 employees who will either elect to fall in line with government designed plans and face penalties for employees that receive tax credits or drop their insurance and pay $2000 per employee to the government. My guess is that many will drop their plans rather than risk government penalties and have to change their plans away from copay plans to the government designed plans. This bill is 2000 pages of bureacratic garbage and if you don't think this is a tax plan then why are they hiring 11,000 more IRS agents. Obama lies about keeping your current plan since virtually all companies have changed plans since the bill was passed which no longer grandfather's their plan. He lies and lies and lies at every turn and needs to be thrown out of office in November to preclude more government mandates intruding into your life.
Frightwingslayer July 06, 2012 at 03:51 PM
Again, I'd like to see the Republican alternative..Ooops, I forgot, it's eat shit and die..Maybe the billionairres who are trying to buy the presidency for Romney ( 100 million donated in June alone) can donate some towards a Republican health care plan..Heh, heh....right..What a lame bunch of losers these Republicans are..
Rosemary B July 06, 2012 at 11:44 PM
As of 2009 their were 3 Republican sponsored Healthcare reform bills. All died in the Democratic controlled Senate. http://cnsnews.com/node/52896
louis kootsares August 22, 2012 at 01:41 PM
adolfh hitler and stalin also forced their will on people besides being mentioned with benedict arnold it is right to include ayahtolla obahma with hitler and stalin

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