ACA's Fate Rests with Court
Justice Scalia suggested that it would be better to have Congress reconsider the entire act rather than on a piecemeal basis. "One way or another, Congress is going to have to reconsider this, and why isn't it better to have them reconsider it—what should I say—in toto, rather than having some things already in the law which you have to eliminate before you can move on to consider everything on balance?"
That argument worries Gerald F. Kominski, PhD, director of the UCLA Center for Health Policy Research. "We don't have a bipartisan solution to the problem. If we return to the status quo, we'll face a crisis."
Justine Handelman, vice president of legislative and regulatory policy for the Blue Cross Blue Shield Association, explains that the loss of the individual mandate would require that other reforms be severed from PPACA, including the guarantee issue provision, pre-existing condition exclusions, and the use of an adjusted community rating system.
Handelman notes that studies of eight states that enacted guaranteed issue and community ratings without individual mandates showed higher premiums, coverage disruptions, and fewer choices for consumers.
The Blue Cross Blue Shield Association filed an amicus brief in support of severing the individual mandate from PPACA if the mandate is ruled unconstitutional.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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