Ever since the Supreme Court issued its ruling to uphold the Patient Protection and Affordable Care Act in June, family, friends and colleagues have been asking me, "What do you think of the ruling? Is it good? Is it bad? Does it matter?"
I found it a bit strange - and I admit, a little amusing - to get these queries. After all, at my core I'm just a magazine editor and concerned citizen. I'm not an attorney, nor a health care professional or even a true benefits practitioner like yourselves.
Still, I felt flattered and humbled that people would ask - that it seemed my perspective on the topic mattered. In the grand scheme of things, maybe it matters; maybe it doesn't. Yet, in case you wondered, here it is:
I think the ruling was unexpected. After covering oral arguments closely in the spring - hearing about the grilling Solicitor General David Verrilli took from the justices and that perceived "swing voter" Justice Anthony Kennedy expressed skepticism of the individual mandate - I fully expected a 5-4 ruling in the opposite direction to strike PPACA's individual mandate but uphold the remainder of the law. To see the decision go the other way - not to mention Chief Justice John Roberts voting with the liberal block to uphold PPACA - was surprising to me, to say the least.
As to whether the ruling is good or bad, only time will tell. I know that's a punt, but I think it's the truth.
Regardless of what the court had ruled, I think PPACA is largely a bad law. Most certainly, PPACA contains some popular provisions - some that I like a lot. I'm quite pleased that I'll no longer be charged higher premiums simply for being born a girl. I'm relieved that my friends with chronically ill children won't have to worry about benefit caps, only about helping their kids live their best and healthiest lives possible. I'm glad that a dear friend recently treated for cancer won't have to worry about being denied coverage down the road due to a pre-existing condition.
Ever since the debate about PPACA started my biggest reservations about the legislation were that it did very little (if anything) to address our nation's high health care costs and even less to improve efficiency and quality.
Our health care system is over-burdened with too much paper, too much testing and too much obesity. Those things are just as true today as they were in June before PPACA was upheld, before March 2010 when PPACA was signed, and they'll be just as true in 2014, when much of PPACA goes into full effect.
So then, does the ruling matter? Yes, I think it does. In upholding PPACA, the Supreme Court has maintained our first-ever national health care policy. It's not a great one, but at least it's a starting point. It took more than 200 years to get there, and there's no telling how long it might have taken to start over again if the court had invalidated the law altogether.
Somewhere between "tinkering" and "repeal and replace," I think there's good policy. We just have to do the work to find it.
EBN Editor-in-Chief Kelley M. Butler is on maternity leave until October. In her absence, please send letters, queries and story ideas to Managing Editor Andrea Davis at firstname.lastname@example.org.
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