St. Mary's Hospital in Passaic has been sold to a for-profit Catholic health care company that plans to create a network of hospitals across the state, officials announced Friday. The purchase price for St. Mary's, which has been struggling financially for years, was not disclosed. The deal will need approval from the state health commissioner. The sale is the first acquisition by the for-profit Ascension Health Care Network and a private equity firm in their effort to purchase three Catholic health care systems with seven hospitals statewide.
There is no underestimating the importance of the Supreme Court decision upholding most of the health reform law—politically, constitutionally and in terms of its practical effects on the nation and the economy. These effects were clear from the moment the decision was announced Thursday morning, but the constitutional picture was more complex. The major exception to the strong legal endorsement of the law involves Medicaid. We disagreed with the court's legal reasoning on this point and believe that without the possibility of withdrawing federal funds, the reform law may fall short of ensuring near-universal coverage.
The reality, of course, is that the health insurance industry was never guaranteed a vastly larger pool of premium-payers. The "minimum coverage" provision (that's the technical name Congress gave what most people have called a mandate) was never to be enforced on its own—that is, the Affordable Care Act has never told people to buy insurance or you go to jail. It was always going to be enforced only by requiring an individual who refused to get health insurance to pay a tax. One might say, then, that what happened on Thursday was that the Court brought into full public view—perhaps for the first time—the fact that the nation’s healthcare market is going to have as customers only those who opt to buy insurance rather than pay a tax.
One of the toughest currents—and ironically the most far-reaching insofar as coverage is concerned—is represented by the Medicaid expansion. Of the 32 million additional children and adults who will have insurance coverage when the Act is fully implemented, a full 16 million stand to be covered through a Medicaid expansion. The effect of this expansion is to reshape Medicaid from a program covering certain categories of the poor into one that offers universal public insurance for all non-elderly low income citizens and long-term legal residents living in poverty.
A number of largely Republican-led states that gambled on delay now face the unsettling prospect that the federal government could take over their responsibilities, particularly in setting up the health insurance marketplaces known as exchanges. Under the law, individuals must be able to buy insurance coverage through the new state exchanges by Jan. 1, 2014. But a more immediate deadline is less than six months away, on Jan. 1, 2013, when states must demonstrate to the Department of Health and Human Services that the exchanges will be operational the next year.
For many people without insurance, a key question raised by the Supreme Court's decision today to uphold the Affordable Care Act is whether states will decline to participate in the law's big Medicaid expansion. Although the court upheld the law's mandate requiring individuals to buy insurance, the justices said the act could not force states to expand Medicaid to millions by threatening to withhold federal funding. Republican leaders of some states already are saying they are inclined to say thanks, but no thanks.