The Supreme Court’s decision to uphold most of the 2010 health care law will be a “relief” for hospital administrators who have been living in limbo as the debate over constitutionality unfolded.
“This will enable us to do a little more planning with some certainty,” said Joe Piemont, president of Carolinas HealthCare System, the region’s largest health care provider.
Doctors and consumers remain divided over the law, with some praising the Supreme Court decision and others contending the law will raise health care costs and violate individual rights.
At Gaffney Health Services on Albemarle Road, about 30 supporters of the Affordable Care Act gathered to celebrate with speeches, cheers and song.
“This ruling provides long overdue peace of mind for our families,” said Pat McCoy, executive director of Action NC, a state partner of Health Care for America Now, “peace of mind that only comes when our loved ones are sure they can receive the health care they need when they need it.”
Speaking to reporters at Carolinas Medical Center, Piemont didn’t give an opinion about the court’s 5-4 ruling that upheld the “individual mandate,” requiring that all citizens buy health insurance or pay a fine. But he said hospitals will benefit because the mandate will mean health coverage for 30 million more Americans and less “bad debt” from patients who don’t pay their bills.
“We provide care without regard to ability to pay,” Piemont said. “To get some reimbursement for that would certainly be a near-term benefit for us.”
Jim Tobalski, a spokesman for Novant Health, which owns Presbyterian hospitals, said Novant supports expansion of health coverage. The system already offers financial assistance to the poor and uninsured, he said, “but many people still fall through the cracks and, as a result, either seek care too late or not at all.”
Dr. Jessica Schorr Saxe, a primary care physician and chairwoman of the Charlotte chapter of Health Care for All North Carolina, was pleased with the court’s ruling. But she said she’s concerned health reform will leave millions uninsured and underinsured, “which leaves them vulnerable to financial devastation from illness.”
Because the Affordable Care Act “does not control the runaway costs of medical care,” Saxe said the country should move toward guaranteed universal coverage through a “Medicare For All” program. It would be paid for by taxpayers but delivered through private physicians and hospitals, similar to Medicare for seniors.
“This would assure everyone health care, as well as provide a better mechanism to control costs.”
Dr. James Hall, a gynecological cancer specialist in Charlotte, disagreed, saying health care is not a right and mandating insurance should not be allowed.
“Government should not have the right to make you purchase a product,” he wrote through the Public Insight Network, a group of readers who offer to share their knowledge with the Observer.
“Purchasing of insurance at group rates makes sense, and the role of government should be to protect against catastrophic occurrences that can be economically devastating. But citizens need to be personally responsible as well. If they smoke, they should pay a higher fee.”
Public response to Thursday’s ruling was divided, mirroring the controversy since passage of the law.
Betsy Gustafson, 51, of Charlotte said the law is already helping her 21-year-old son, Anders, by allowing him to stay on the family’s insurance.
Anders has autism and attends Central Piedmont Community College, but he can’t handle a full load of classes. As a part-time student, he couldn’t have stayed on his parents’ plan before health reform. When Anders was a child, the family’s insurer wouldn’t cover him because of his “pre-existing condition,” Gustafson said.
The Affordable Care Act allows young adults to stay on their parents’ plans until age 26. It also prohibits insurers from refusing to cover children with pre-existing medical conditions, and it expands that prohibition to adults in 2014.
“People who are against (the law don’t) realize how it affects families like mine and what we’ve had to go through,” Gustafson said through the Public Insight Network.
Because of the law, Debbie Moschak, 26, of Charlotte was also allowed to stay on her parents’ insurance while she looked for a job after graduating from college in 2008. During that time, she developed health problems that resulted in four operations. Her parents’ insurance paid about $20,000.
“It wasn’t anything I could have prevented. My body just decided to screw up one day,” said Moschak, who moved to Charlotte three years ago and now has a job with benefits.
However, other Charlotteans complain the law has contributed to rising health insurance premiums.
Pel Deal, 51, a self-employed information technology specialist, said his premiums have risen from about $260 to $863 per month since 2008. At the same time, his plan changed from having no deductible to a $5,000 deductible.
“If it goes up anymore, I don’t think I can afford it,” said Deal, a member of the Public Insight Network.
Before requiring everyone to buy insurance, Deal said government should limit what hospitals can charge. He suggested regulating health care pricing “the same as they do electricity or water.”
Dana Pressley, a Charlotte homemaker, criticized the law for contributing to rising costs and government interference.
“Our freedoms are being eroded,” she wrote through the Public Insight Network. “There will be rationing. Bureaucrats will make our health care decisions. … True free market competition is the best way to bring prices down.”
Officials at Blue Cross Blue Shield of North Carolina said health reform has affected premiums minimally. Maybe 1 percent of an increase is attributable to expenses associated with new benefits under the law, said spokeswoman Michelle Douglas.
“It’s really the cost of health care and the number of health care services used that are the biggest factors driving rates,” Douglas said. “That was the case before reform. That’s the case now. And it will continue to be the case in the future.”
Staff writer Joanna Nolasco contributed.