Thursday, February 28, 2013

Constitutional or Not, It’s a Win-Win for the Health Insurance Industry

The recent Supreme Court hearing on the constitutionality of the Affordable Care Act (ACA), or �ObamaCare,� has reopened the false debate surrounding the President�s signature legislation.

Whether to uphold or strike down the ACA isn�t about how to provide truly universal healthcare in a sustainable way. Common sense solutions such as improving and expanding Medicare to everyone were kept completely off the table as the law was being written. The ACA is designed to bail out the for-profit healthcare industry before their profits flat line and the court�s decision will reflect how best to do that.

The health insurance industry spent $1 million a day to influence the national healthcare reform debate in their favor. Written by Liz Fowler of the nation�s largest insurer, WellPoint, the law delivers 30 million new customers and $447 billion in taxpayer subsidies directly to the private health insurance companies.

If fully implemented, the ACA will leave at least 23 million people uninsured, egregious insurance company practices such as charging older people more for policies, denials and delays in approving care, and high rates of medical bankruptcies due to inadequate insurance plans, will continue.

The Supreme Court�s ruling, expected by the end of June, could have a number of different outcomes.

1) The punt: The Court could punt the decision on the constitutionality of the law until after the insurance mandate goes into effect in 2014 and someone has actually been fined for not purchasing health insurance. The court would then take up the case again in 2015 when people have to provide proof of health insurance when they file their taxes.

2) Throwing out the mandate: The Court could toss out the mandate declaring it unconstitutional, affirming the arguments that mandating people to purchase private health insurance is beyond Congress� role of regulating interstate commerce. The rest of the law could remain intact allowing some of the beneficial provisions to be implemented such as the Medicaid expansion and the regulation of health insurance company practices.

3) Throwing out the whole thing: If the mandate is deemed unconstitutional, the court rules that entire law must be struck down. Without the mandate, the ban on preexisting conditions restrictions and community rating provisions would drive up costs and reduce coverage. The mandate is therefore inseparable from the entire law and the entire law will be struck down.

4) Upholding the law: This Supreme Court has a track record of ruling in favor of the corporate interests (see Citizens United), and the ACA is based on legislation crafted by the health insurance industry. This should not be a surprising outcome. If the law is thrown out and the status quo in healthcare continues, the insurance companies are left with a playing field stacked in their favor without regulations that may eventually threaten profits. Costs will continue to skyrocket; more people will be without insurance.

If the ACA is upheld, many of the law�s provisions won�t be enacted for another two years, plenty of time for the industry to whittle down regulations that get in the way of profits and still have the 30 million customer stimulus. The Supreme Court will rule according to what is best for the corporate interests. Upheld or struck down, the for-profit healthcare model continues to take public money for a public good and make obscene profit. The opposition to the legislation mostly came from people saying the law doesn’t go far enough in making healthcare a right.Recognizing the enemy in this debate is a first step toward building unity in fighting back.

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