Nelson: Activist Supreme Court will likely trigger rising health costs, jeopardize care for children with pre-existing conditions
WASHINGTON -- Today, Nebraska's Senator Ben Nelson said health insurance premiums will rise for millions of Americans and health care will be jeopardized for children with pre-existing medical conditions if the activist U.S. Supreme strikes down all or part of the Affordable Care Act as expected soon.
"Nebraskans and all Americans should be troubled that an activist U.S. Supreme Court could soon undo part or all of the landmark health reform law with serious consequences for families, young adults and children," said Senator Nelson. "The activist Supreme Court expected actions could send health insurance premiums skyrocketing and endanger health care for more than 100,000 Nebraska kids with pre-existing medical conditions such as asthma or diabetes.
"When the activist Supreme Court breaks health reform, the Tea Party wing and others will have an obligation to fix it," the senator added. "The Court could eliminate the individual mandate or overturn the entire law. At a minimum, that will unleash a $78 billion hidden tax that Americans with insurance pay for those who can't or won't get health coverage. It will create uncertainty in America's health care system and renew difficulties for millions of Americans in securing affordable and effective health care."
This month, before its current session ends, the U.S. Supreme Court is expected to issue a ruling on challenges to the Affordable Care Act. The court has been asked to declare unconstitutional the law's requirement that all Americans obtain health coverage, known as the individual mandate. It also has been asked to overturn the entire Affordable Care Act on constitutional grounds.
Nelson noted that the individual mandate was once a key Republican health care proposal and a provision that America's health insurers insisted be included in the Affordable Care Act. The requirement to obtain health insurance is a key way to extend coverage to 30 million Americans who today are not insured. That, in turn, will dramatically reduce the amount of cost shifting in health care where Americans who have insurance pay hidden extra costs in their premiums to cover the costs of those who don't have insurance but receive care, often at high-cost emergency rooms.
"If those who break the law fail to fix it, it'll be clear that they never wanted to help Americans whose health care premiums rise nearly 10 percent a year or children with pre-existing medical conditions," Nelson said. "It'll be clear what their motivations were all along: just to play politics."
Nelson said they will not have to start from scratch to develop alternative ways to reverse the trend of increasing healthcare costs and eliminate the unfair tax the insured currently pay to cover the cost of those who either cannot afford or choose not to be insured.
In the spring of 2010, Nelson asked the Government Accountability Office to investigate ways to increase insurance enrollment without an individual mandate, given "the possibility that legislative or judicial action could result in a change to, or elimination of, the mandate." The GAO report, published in 2011, outlined nine alternatives and their potential challenges, drawn from interviews with 41 health care experts in 21 organizations from a broad range of perspectives.
Before outlining the alternatives, the GAO noted the Congressional history of the individual mandate and its intended policy goals, including to allow for a ban on pre-existing conditions and to reduce the costs of uncompensated care. Uncompensated care is what Americans who have insurance pay for the care those who don't have insurance, either because they refuse to buy it or cannot afford it. The GAO found that in 2008 this hidden tax cost Americans $57 billion.
More recently, The Urban Institute published a report in January 2012 noting the level of uncompensated care now totals $78.5 billion. This study found that the share Nebraskans paid was $431 million in uncompensated care for those who receive care but don't pay.
The GAO report, Private Health Insurance Coverage: Expert Views on Approaches to Encourage Voluntary Enrollment, can be found here.
The Urban Institute study, State Progress Toward Health Reform Implementation: Slower Moving States Have Much to Gain, can be found here.