The Supreme Court is expected to decide the constitutionality of the individual mandate, which also impacts other provisions of the law, including a requirement health insurance companies provide insurance coverage for those with pre-existing conditions. Disagreements are reflected in internal polling of the physicians group, in which 19% showed they wanted a complete rejection of the law, and—at the other end of the spectrum—18% didn't believe it "went far enough" in insurance coverage.
"The (individual) mandate is the one piece that people legitimately have fundamental differences of opinion (about)," Stream says. "The other provisions, I think, pale in comparison. But our policy for 20 years is that everyone should have access to health insurance coverage of some kind. I have not seen anybody making a convincing argument that you can get everybody covered, without a mandate. Is a mandate the ideal thing? No."
So what happens if the Supreme Court doesn't touch the law, or just overturns a few sections, and not the individual mandate? With so many more physicians opposing the law, there is certainly going to be more disappointment spread around. For some older doctors who hope the Supreme Court strikes down the measure, a court decision to uphold it means they will exit the world of being a provider that much sooner.
Hal Scherz, MD, a 57-year-old urologist in Georgia, who founded an organization Docs4 Patient Care, in part, to fight the law, is adamant that the high court's approval would be a turning point in his career. "My time horizon will truncate," he says, noting that he would quit the profession sooner than he would have anticipated.