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Hear President Obama
President Barack Obama says the Supreme Court's decision to uphold his health care overhaul is a "victory for people all over the country" and will make their lives more secure.
Obama says the decision upholds the fundamental principle that in America - the wealthiest nation on earth - no one should fall into financial ruin because of an illness.
The president says the decision means that people with pre-existing medical conditions will not be discriminated against and people will be able to afford quality health care.Polling has suggested that most Americans oppose the law and Republican presidential candidate Mitt Romney vowed again after the ruling to seek its repeal.
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Presidential Candidate Mitt Romney
He called the decision incorrect and said Thursday that it is "bad law." He says it raises taxes and cuts Medicare.
Romney says that, if elected in November, he will work to repeal and replace the law. But he hasn't said precisely how.
As Massachusetts governor, Romney signed into law a measure that required all state residents to have health coverage. That notion was the cornerstone of the law enacted by President Barack Obama and congressional Democrats. The high court decided it was constitutional.
Congressman Brian Higgins has issued a statement regarding the Supreme Court's decision upholding the individual mandate on health care reform.
“Today the Supreme Court, in an opinion authored by Chief Justice John Roberts, held that the Affordable Care Act is constitutional. Under the law, this year over 3 million New Yorkers have begun receiving free preventative care, over 3,000 New Yorkers with pre-existing conditions are no longer denied health insurance coverage, 160,000 young adults in New York State are now receive health coverage through their parents’ plan, and 254,083 New York State seniors on Medicare are saving an average of $655 on their prescription medications.
“The old way of doing business was unaffordable, unacceptable and unsustainable for taxpayers and patients alike. Despite exorbitant expense, according to the World Health Organization, the United States is 37th of 192 countries in terms of overall healthcare quality.
“The Western New York health community is already leading the way on health reform. They have embraced electronic medical records and the formation of comprehensive care organizations. This law gives Western New York the tools we need to go farther and it gives the rest of the country the opportunity to follow our lead.
“Much of the Affordable Care Act was modeled on the Cleveland Clinic standard, care Western New Yorkers frequently travel to receive. Cleveland Clinic quality care is the health care I want for my family, my community and my nation.”
Statement by Health Association of NYS President Daniel Sisto:ALBANY, NY — “New York’s hospitals and health systems are pleased that the Supreme Court decision makes possible the extension of health insurance coverage to 32 million Americans. Insurance will be made more affordable, particularly for those with pre-existing conditions among others who had been effectively shut out of the health insurance marketplace. Achieving universal coverage through affordable and comprehensive insurance is a cornerstone of HANYS’ mission.
“This decision will also continue to spur health care providers to reduce health care costs and improve patient care through innovations in the way health care is provided. We already see hospitals and other health care providers in New York making these kinds of changes, even as they face repeated, deep cuts in reimbursement from Medicare and Medicaid.
“As we help providers change and respond to the Affordable Care Act (ACA), HANYS will continue to fight against unreasonable cuts, so that health care providers can reform the delivery system while preparing for the increased demand within their communities for health care services as coverage is expanded.
“While ACA expands health insurance coverage, there will still be millions of Americans without coverage. The challenge going forward for the nation will be to close that gap and achieve universal coverage.”
"The Supreme Court’s decision today upholding the controversial Affordable Care Act and its heavy-handed individual mandate is a deep disappointment to small businesses everywhere, said the National Federation of Independent Business (NFIB) today......
“While we are certainly disappointed, NFIB respects the decision to uphold the individual mandate by the Supreme Court. Clearly this mandate has now become a tax on all Americans and a broken campaign promise from President Obama not to raise taxes,” said Dan Danner, President and CEO of the National Federation of Independent Business. “We are concerned about the precedent that this will set in Congress’ ability to mandate other aspects of our lives, but we will move forward from today to continue to fight, harder than ever, for real health-care reform for our membership.
“Under PPACA, small-business owners are going to face an onslaught of taxes and mandates, resulting in job loss and closed businesses. We will continue to fight for the repeal of PPACA in the halls of Congress; only with PPACA’s full repeal will Congress have the ability to go back to the drawing board to craft real reform that makes reducing costs a number one priority. The power and control of health-care decisions should be in the hands of the consumer, not the government.”
“This day will go down in history as the day when Americans lost a part of their freedom – the freedom to choose what to buy with their own money.” said Karen Harned, Executive Director of NFIB’s Small Business Legal Center.
NFIB State Mike Durant said the ruling guarantees that New York residents will have their most personal health care decisions made by politicians and bureaucrats in Washington and in other states whom they’ve never met and whom they’ll have a hard time influencing in the future.
“The tragedy in this ruling is that New York residents are now at the mercy of politicians from other states and bureaucrats in Washington whose decisions won’t be based on what is best for New York,” said Durant. “Small businesses here will be overwhelmed by mandates, taxes and burdens imposed on them by people whom we cannot as easily hold accountable.”
Representative Kathy Hochul (NY-26) released the following statement in response to the Supreme Court ruling on the Affordable Care Act:
“Today’s Supreme Court ruling provides much needed clarity in an important national debate on the appropriate role of the federal government in the delivery of healthcare. While I was not in Congress to vote on the Affordable Care Act, I have always believed, and continue to believe, that the law is far from perfect, and I remain concerned about the high cost of implementing the law.
That is why I have worked to roll back many of its most troubling provisions, including the financially unsustainable CLASS Act, the Medical Device tax, and the Independent Payment Advisory Board, which could result in the rationing of Medicare.
“I am hopeful that today’s ruling will help to focus our country on the need for more effective policies that drive down the cost of care and ensure that all Americans—especially children, seniors and veterans—have access to quality and affordable health care.
I stand ready to work with my colleagues on both sides of the aisle to continue to improve the law and find appropriate solutions to the rising cost of health care in this country.”
The National Republican Congressional Campaign Committee:
BlueCross BlueShield of WNY:
"BlueCross BlueShield of Western New York, the largest health insurer in the community whose roots date back to 1936, are committed to adhering to the United States Supreme Court’s ruling regarding the Affordable Care Act (ACA). The Supreme Court, the highest ranking court in country, ruled that the ACA has been upheld in its entirety.
The basis for today’s Supreme Court decision originated from legislation that was created to address the fundamental principle and belief that all Americans should have access to quality, affordable health care.
This historic decision, regardless of where individual opinion may reside, will impact the future of health care in our country. The nation’s conversation around the issue has already created momentum for innovation and increased awareness around the drivers of medical costs.
“For more than 75 years, we have been committed to provide high-quality health care coverage, offering security and stability to our members,” Alphonso O’Neil-White, President and CEO, BlueCross BlueShield, said. “As we continue to implement the law, we will work with policymakers to resolve provisions in the Affordable Care Act that result in increased costs. On behalf of our BlueCross BlueShield of Western New York members, we will continue to lead efforts in local communities — partnering with doctors, nurses, hospitals, and others — to help people stay well, control costs, improve quality and better manage their care when they need it.
“We’ve seen many changes in health care over the years. The one thing that hasn’t changed — and will not change — is our commitment to providing our members security and stability when it comes to their health care.”
“...As the market leader in the region, the impact of this ruling touches our members, health care and professional partners, and community entities, and we are pleased to provide a forum that is inclusive through technology.” O'Neill-White said
Kaleida Health today released the following statement regarding the Supreme Court decision to uphold the 2010 Affordable Care Act:
James R. Kaskie, the president and CEO of Kaleida Health said,
“Now that the Supreme Court has announced its decision, we must move forward as a nation. The Patient Protection and Affordable Care Act (PPACA; Public Law 111–148), while controversial and complex, has helped engender a national debate and discussion about the need to change our health care system.
Simply put, we must continue to find ways to improve quality and access while reducing cost and variation in care.
“Here in Western New York, we are building a healthier future. We continue to work with our physicians, nurses, and staff to revolutionize and re-engineer our health care delivery system.
Together, we are creating centers of excellence, eliminating duplication, right-sizing, and most importantly, improving the quality of care for the patients we serve.”
The National Council of Chain Restaurants Executive Director Rob Green issued the following statement:
“Today’s decision will impose costly burdens on the chain restaurant industry, thousands of small business franchisees and their employees.
Throughout the legislative debate on the ACA and over the last two years, NCCR has voiced the industry’s consistent concerns that the law would do significant harm to job growth and the economy. We’re afraid that continues to be the case as the industry braces itself for 2014.
“The ACA imposes heavy mandates on employers using punitive penalties for non-compliance. The law will particularly damage the chain restaurant industry, which operates on thin margins and cannot support costly government imposed mandates.
" Many chains have indicated they will have no choice but to cut back on workers’ hours or close restaurants in order to avoid the penalties.
“NCCR opposed the ACA and has advocated instead for reforms that expand access through lower costs. In 2009, Congress and the president went about health care reform the wrong way.
"Instead of making health insurance more affordable, they focused on unrealistic mandates and penalties that do nothing but punish employers and weigh down the economy.
“NCCR will continue to work to repeal the ACA and replace it with common-sense reforms that lower the cost of health care insurance for all Americans.”
The National Council of Chain Restaurants is the leading trade association exclusively representing chain restaurant companies.
Statement from New York State Attorney General Eric Schneiderman
WASHINGTON – The following statement can be attributed to Attorney General Eric T. Schneiderman in response to the U.S. Supreme Court’s decision today to uphold the Affordable Care Act. In 2011, Attorney General Schneiderman filed a brief in support of the law.
“The Supreme Court's decision to uphold the Affordable Care Act is an historic victory for the tens of millions more Americans who will be covered by health insurance. The law's effects will be significant in our state, where over two million people are uninsured.
Over a million uninsured New Yorkers will soon have access to affordable coverage. This law will continue to provide a spectrum of key consumer protections including keeping young adults on their parents' plans, ending pre-existing condition restrictions, and increasing consumer information about health care choices. My office stands ready to enforce the Affordable Care Act to ensure that all New Yorkers will benefit from the law's protections.”
Statement from Cong. Tom Reed (R- Corning):
“I respect the Supreme Court’s decision to essentially uphold Obamacare, but I am very troubled by the ramifications. This decision greatly expands the government’s ability to tax and interfere in people’s lives. This is bad news for patients, taxpayers and the economy.
“Health care premiums continue to rise at a rate much higher than inflation and the mandates of the act are having a chilling impact on job creation.
Businesses legitimately fear anticipated cost increases when the law is fully implemented next year. We need to fully repeal the Affordable Care Act.
“The reality is that as the law stands, Obamacare will cost trillions and will be paid for by billions in tax increases and a $500 billion reduction in funding for Medicare.
“I will continue to work to repeal this law. What we need to do is carry forward with patient-centered reforms such as requiring coverage for pre-existing conditions, allowing children up to age 26 to be carried on a parent’s policy, and covering preventive health care services like mammograms for women.
“The nation will have to make a decision at the polls this November regarding what direction to go.
People will need to choose between repealing Obamacare or continuing to a future of massive tax increases on individuals and businesses and a significantly larger, more invasive government.
I believe in individual choice and empowering patients rather than health care by unaccountable bureaucrats or administrators.”
Gov. Andrew Cuomo :
"Thanks to the leadership of President Obama and his administration, particularly Secretary Sebelius, the Affordable Care Act will provide access to health care to millions of Americans nationwide and more than one million New Yorkers, and I am pleased the Supreme Court upheld this law.
We will continue to move forward with implementing the health exchange that will lower coverage costs for New York's businesses and help ensure that uninsured New Yorkers have access to health care. We look forward to continuing to work together with the Obama administration to ensure accessible, quality care for all New Yorkers."
NYS Assembly Speaker Sheldon Silver:
Today's ruling by the United States Supreme Court on the constitutionality of the landmark Affordable Care Act (ACA) is a significant victory for all Americans, including more than two million uninsured New Yorkers who will benefit from this historic law.
New York has long been a leader in healthcare reform, including taking the lead to implement this law. Because of the ACA, 160,000 young adults in New York have gained insurance through their parents’ plans, more than 3,400 New Yorkers with pre-existing conditions are now covered through the New York Bridge Plan, and more than a quarter million seniors received a prescription drug rebate.The message sent today is loud and clear -- the individual mandate is constitutional and no one should have to live without affordable and quality health insurance. I hope that with this ruling, Republicans will finally stop playing politics with our health and well-being and work with Democrats to erase the healthcare disparity we are faced with, particularly for our working families, seniors and children."
Statement by NYS AFL-CIO President Mario Cilento on Supreme Court Affordable Care Act Decision:
"The Supreme Court confirmed what we all knew: opposition to health care reform was about politics and maintaining the status quo.
Dr. Robert J. Hughes, President of the Medical Society of the State of New York:
"Now that the decision has been reached by the Supreme Court, it is time for Congress and the President to put aside partisan differences to work together to fix the many flaws of the PPACA law that have been identified by the many physicians who opposed the law as well as the many physicians who supported many of its provisions, to better assure that the goal of law is met – assuring patients can receive timely quality health care from the physician of their choice.
Peter Morici is an economist and professor at the Smith School of Business, University of Maryland, and widely published columnist.
Morici writes: "The Supreme Court decision upholding the Affordable Health Care Act requirement that individuals purchase health insurance or pay a tax, as well as most other provisions regulating the health insurance market, may ultimately instigate a single payer system, akin to the British National Health Care Service.
The vast majority of Americans believe that all citizens are entitled to some reasonable access to health care. However, folks with chronic conditions or a medical history indicating high risk often cannot purchase health insurance and face financial ruin from medical bills.
Also, many people tend to forgo health insurance until they develop a chronic condition or otherwise expect to encounter large medical bills. Consequently, individual policies, even for the healthy, are often prohibitively expensive or offer severely limited benefits.
Both groups end up in emergency rooms and hospitals when conditions become acute and can't pay their bills. The rest of us pick up the tab through significantly higher insurance premiums and government subsidies.
Most liberals and a few conservatives argued the individual mandate was necessary, along with the ACA requirement that insurance companies not deny coverage or set rates on the basis of preexisting conditions, is necessary to ensure that everyone have access to reasonably priced health care.
Maryland already compels insurance companies to take all comers and not discriminate in the rates they charge, but unlike Massachusetts, the state does not impose an individual mandate. However, thanks to a requirement that employers cover employee dependents until the age of 26 and a well regulated system as compared to other states, an individual mandate was proven unnecessary to spread the extra cost of insuring individuals with preexisting conditions or without employer coverage across the entire insured population.
Rather, the individual mandate was just a political deal between the Obama administration and insurance companies - the latter will get millions of new healthy policyholders and attendant profits-and it is much like other deals the President made to co-opt pharmaceutical manufacturers and health care providers and dragoon a bad law through Congress.
However, the ACA does not solve the broader affordability problem bedeviling business and middle class families facing rising premiums, co-pays and burdensome claims processes
The law provides subsidies for low and moderate income individuals to purchase health care and assistance to small businesses-together with the individual mandate, these should lower the number of Americans without insurance from 50 million to about 30 to 35 million. These subsidies will accelerate health care inflation-the costs of drugs, doctors' visits, hospital stays, administrative costs, and malpractice suits will rise faster than ever, making health insurance increasingly unaffordable for businesses and middle-income individuals.
The ACA requires the Office of Personnel Management to sponsor, through private firms, two health plans-those public options will be advantaged by larger taxpayer contributions and exemptions from critical regulations imposed on private insurers.
Businesses will have a strong incentive to push employees into one of the two public plans or drop coverage altogether and pay the $2000 penalty imposed by the ACA. Middle and upper income employees displaced from employer-based plans will likely find one of the "public options" the least expensive and most sensible choice.
Once one major firm in a market-be it a national market like autos or local market like dry cleaners-drops private insurance in favor of a government plan, or drops health coverage altogether and simply pays the $2000 per employee fine, others will be compelled by price competition to follow.
All along, the OPM-sponsored plans were a Trojan Horse. They will be advantaged over private insurers even with the individual mandate helping pull down the latter's costs per enrollee. With the ACA pushing health care costs ever higher, the artificial price advantage of government-sponsored insurance will be too big to resist."
From The American Cancer Society:
Ruling Preserves Critical Patient Protections for Families Affected by Cancer
“The ruling is a victory for people with cancer and their families nationwide, who for decades have been denied health coverage, charged far more than they can afford for lifesaving care and forced to spend their life savings on necessary treatment, simply because they have a pre-existing condition, said John R. Seffrin, PhD, CEO of the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN).
The decision ensures that critical patient protections benefitting cancer patients and survivors will be implemented, such as those prohibiting insurance companies from denying coverage to people with a pre-existing condition, requiring insurers to provide consumers with easy-to-understand summaries about their coverage and requiring health plans in the individual market to offer essential benefits needed to prevent and treat a serious condition such as cancer.
“Access to care saves lives. Scientific research from the American Cancer Society has shown that people without health coverage are more likely than those with private insurance to be diagnosed with cancer at its more advanced stages and less likely to survive the disease,” said Blair Horner, Vice President of Advocacy, American Cancer Society of NY & NJ. “Now that the Supreme Court has ruled, it is time for all of our elected officials in New York to work together in a bipartisan effort to implement the health care law as strongly as possible for cancer patients, survivors and their families.”
In New York, and in every state across the country, patients will have access to an online marketplace, or exchange, where they can easily compare quality health plans and choose the one that is best for them and their families. New York has received $88 million in federal aid to set up the health insurance exchange. Gov. Cuomo issued an executive order setting up the skeleton of an exchange earlier this year. Additional steps include making decisions on how the exchange will operate and beginning to hire staff.
The ruling preserves vital provisions that are already improving the ability of people with cancer and their families to access needed care by ensuring that proven preventive services such as mammograms and colonoscopies are offered at no cost to patients, eliminating arbitrary dollar limits on coverage that can suddenly terminate care and prohibiting insurance companies from unfairly revoking coverage when a person gets sick"
Russell Sykes analyzes Health Care at the Manhattan Institute, a Conservative NYS Think Tank:
But on the Medicaid expansion that would add more than 16 million people to Medicaid nationwide, the court appears to agree with 26 states that challenged the provision, by not allowing the federal government to withhold current Medicaid funding for a state that does not choose to expand eligibility.
Without threat of penalty, a number of states may not expand their rolls. But, New York did not challenge the provision and is unlikely to opt out of the expansion.
So, one might think the ruling provides clear sailing for New York to get on with implementing Gov. Cuomo’s bold health reform plans. Not so fast.
The decision does make the state Health Insurance Exchange Cuomo created by executive fiat in April viable as a marketplace for individuals and small businesses to purchase health insurance. The mandate remaining intact ensures that younger healthier purchasers will offset the costs of higher-risk and less healthy purchasers.
But for his Medicaid Redesign Team’s ambitious Medicaid reform plans, it’s still far from a sure bet.
Most of his sweeping Medicaid proposals have less to do with the court decision — instead they depend greatly on a less visible, but more important, federal sign-off on a major expansion of the state’s Medicaid waiver authority.
Section 1115 of federal Medicaid law allows the Center on Medicaid and Medicare Services (CMS), which oversees Medicaid federally, to permit states to experiment with major proposed reforms that are outside of existing Medicaid law and regulations.
And New York is in the process right now of submitting the largest 1115 waiver ever to CMS in both policy scope and the amount of federal funding being requested for reinvestment. New York estimates that the waiver will save $34 billion in Medicaid costs over five years, with half of that, or $17 billion, being federal savings. And the ask of the federal government is to give $10 billion of their savings, or $2 billion annually, for five years back to New York for investing in broad Medicaid and overall health system reforms.
New York plans to submit the full waiver in the late summer or early fall and hopes to have an answer by the end of this year. Certainly it is a worthy pursuit, but even Jason Helgerson, New York’s Medicaid Director, acknowledges that approval is by no means a sure thing.
Why would the feds agree to committing to such a large sum of money to New York, based on projected savings, when their own fiscal situation is so dire, you might ask?
No matter what the merits of the proposal, and it is mostly sound, growing deficits, skyrocketing long term debt and the nearly unbridled growth of entitlement programs including Medicaid and Medicare, stand in the way of approval.
So, the court has spoken. But the decision by no means clears New York’s path to reform. When the court decision is digested further and the frenzy dies down, yet another nail-biting waiting period begins for New York.