Court ruling on health care could cost us

Bill Knight column for Thurs, Fri. or Sat., June 28, 29 or 30


In the realm of unintended consequences, the U.S. Supreme Court could cost Americans dearly if corporate-cozy conservatives Samuel Alito, John Roberts, Antonin Scalia and Clarence Thomas can convince swingman Anthony Kennedy to overturn some or all of the Affordable Care Act – including $61 million in rebates for more than 300,000 Illinoisans.

As this is written, the Court (USSC) has yet to rule on health care reform, which ensures that people with preexisting conditions must be covered and young adults can remain on parents’ plans, among other popular provisions.

If the USSC lets the law stand, more than 12 million Americans in the next month will get $1.1 billion in refunds from health insurers that overcharged them last year under the law’s “80/20 rule.” That requires insurers to spend no more than 20 percent of customer premiums on administration, CEO pay and profits, and to use the rest for actual health care.

“This is a big deal for families,” said Ethan Rome, director of Health Care for America Now (HCAN). “For far too long, health insurance companies have been ripping off consumers, and Obamacare finally put a stop to that.

“These refunds are a powerful example of what Obamacare does for hard-working families, seniors and small business owners,” he continued. “Every consumer should know that the only reason they will get the refunds is because of Obamacare, and the Republicans in Congress want to take those rebates away.”

The average rebate for affected people will be $151, but in Illinois, the averages are higher: $176 for the 74,000 people in large group plans, $199 for 60,000 people in individual plans, and $551 for the 164,000 people in small group plans, HCAN shows.

Other consequences of the USSC overturning the law could include 5 million seniors who’ve received prescription-drug rebates required to repay the money, improvements to Medicare helping doctors and hospitals erased, and 18-to-26 year olds now on parents’ plans dropped. (Illinois law still provides parents with the option of keeping unmarried dependents on their health care insurance up to age 26, and keeping dependents who are veterans up to age 30.)

AFL-CIO president Richard Trumka last month said if the Court overturns the law, “it would stand the country on its head.” Health care would be thrown in chaos and “a lot of people would be hurt.” Trumka and many progressives favor improving the law by adding a public insurance option and the ability of the government to use its massive buying power to negotiate lower drug costs from big pharmaceutical companies.

If the USSC overturns the mandate – proposed by the conservative Heritage Foundation in the ’80s, and supported by Republicans Newt Gingrich (in the ’90s) and Mitt Romney (a decade later) – insurers couldn’t spread the risk and would probably raise premiums and/or deny coverage. Nationally, some 50 million Americans would be “free riders,” unable or unwilling to buy insurance and relying on emergency-room visits for treatment – visits that ultimately are borne by everyone else. (In Illinois in 2010, the percentage of private employers offering health insurance to workers was only about 51 percent.)

Of course, such use of tax laws is common, which is why homebuyers have tax breaks (and renters don’t), why charitable donors, parents and owners of hybrid cars get tax advantages (and those who can’t contribute, don’t have kids or won’t buy hybrids are financially punished). Smokers and gasoline users pay more taxes than non-smokers and public-transportation riders.

If the Court’s conservative extremists continue their recent record of harmful, nonsensical rulings, like “Citizens United,” the health care crisis – made much worse by the Great Recession – will be back with a vengeance. With health care reforms not fully enacted, the U.S. system is the world’s most expensive (50 percent costlier than No. 2, Norway, and taking up almost 1/4 of the federal budget), yet life expectancy ranks 27th worldwide. Health providers’ fee-for-services arrangement encourages more procedures and tests, and doctors and medical centers charge a lot.

“We rank behind at least two dozen other countries in health care results, but our per capita expenditures far exceed those of any other country and our health care costs are inflating at an explosive rate,” says retired attorney James Van Vliet in Chicago. “We are the only developed nation without universal health care.”

No matter how the USSC rules, the public is unlikely to be satisfied with the decision, according to a June survey by the Pew Research Center, which said, “Whether the Court decides to uphold the entire law, overturn the entire law, or reject the ‘individual mandate’ while allowing the rest of the law to remain, fewer than half of Americans say they would be happy with the decision.

“Many Americans do not have a clear understanding of what’s in the health care law,” Pew added.