Players in the upstate New York market are responding after the U.S. Supreme Court upheld nearly all of the 2010 federal health-care reform law this morning, including the individual mandate.
The mandate, which requires almost all Americans to purchase health insurance or pay a penalty, can be upheld under the federal government’s taxing power, the court said in a 5-4 decision. Its ruling leaves most of the reform law, the Patient Protection and Affordable Care Act, intact.
The court did deem unconstitutional a part of the law that deals with expanding the Medicaid program. The federal government cannot threaten to withhold existing Medicaid funding from states that do not expand the program, the court ruled.
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CNYBJ.com will update this story throughout the day with local reactions to the court’s decision. Check back to see the latest from business leaders, health-care organizations, and other groups with a stake in the ruling. Latest update: 4 p.m.
4 p.m. update
Onondaga County Medical Society President Dr. David T. Page called on the federal government to do more to entice medical students to enter primary care, preserve funding for graduate medical education, and provide funding for hospitals. Page also said physicians will practice expensive “defensive medicine” without medical liability reform.
“Whether you agree or disagree with the U.S. Supreme Court’s decision, we must begin to focus immediately on what future changes can and should be made in our country’s health-care delivery system,” Page said in a news release. “The Onondaga County Medical Society and its member physicians support future steps that would allow all patients to have access to proper medical care at the right time and in the right setting.”
Thomas J. Crowley, the chair of the board of the DeWitt–based Independent Insurance Agents & Brokers of New York, Inc. (IIABNY), said independent agents and brokers will have a role to play after state-run insurance exchanges come online.
“In view of today’s ruling by the Supreme Court of the United States, we expect that the administration of Gov. Andrew Cuomo will continue its efforts to create a health-insurance exchange in New York, as required under the Affordable Care Act,” he said in a news release. “IIABNY and its member agents and brokers continue to believe that New York consumers and small-business owners will be best served by the strong involvement of insurance producers in the exchange. Health-insurance plans are complex contracts with many options. The financial consequences of making uninformed choices can be severe. When making important decisions that affect the health of their family members and employees, New Yorkers need and deserve qualified, professional advice.”
UnitedHealth Group provided the following release:
“Health-care modernization did not begin and must not end with the enactment of the Patient Protection and Affordable Care Act. UnitedHealth Group strongly supports making high-quality health-care accessible and affordable for everyone, and now is the time to apply proven ideas and best practices to build a better health-care system.”
3 p.m. update
Excellus BlueCross BlueShield, Central New York’s largest health insurer, issued this statement:
“No matter what the court was going to decide, we’ve kept our focus on what matters most to our customers — offering quality and affordable health coverage at the lowest possible price. That’s what we’ve done for eight decades. That’s what we’re going to keep doing. We’ll be closely studying the ruling over the next several days, so we won’t have a deeper analysis for you until that review takes place.”
St. Joseph’s Hospital Health Center President and CEO Kathryn Ruscitto expressed optimism that the ruling will increase access to health care, but she also referenced a federal rule that will require most insurance plans to charge no co-pays for contraceptives. Catholic leaders have objected to that requirement as a violation of religious employers’ liberty.
“Regardless of how the decision may be interpreted, or how the law may be modified in the future, St. Joseph’s will remain dedicated to improving quality, increasing access, and decreasing costs of health care,” Ruscitto said in a statement. “We’re pleased that access to health care will be enhanced but concerned about possible reductions in our reimbursement. We’re hopeful that the issues of religious freedom will be resolved in the near future.”
1:50 p.m. update
MVP Health Care has complied with the Affordable Care Act as its different parts went into effect, the not-for-profit insurer based in Schenectady said in a news release. It is preparing to sell policies through New York’s health-insurance exchange in 2014.
“Now that the [Affordable Care Act] has been upheld by the court, it is time to continue the work of reforming the health-care system,” MVP President and CEO David Oliker said. “This includes addressing America’s real health-care problem by introducing legislation to reduce the unsustainable increases in the cost of health-care services and products. Some of the most promising ways to control costs are to incentivize providers for delivering quality outcomes in a cost-efficient way, to promote the use of evidence-based medicine, and to encourage the meaningful use of health-information technology/electronic medical records and e-prescribing.”
New York Gov. Andrew Cuomo released the following statement:
“Thanks to the leadership of President [Barack] Obama and his administration, particularly [Health and Human Services] Secretary [Kathleen] Sebelius, the Affordable Care Act will provide access to health care to millions of Americans nationwide and more than one million New Yorkers, and I am pleased the Supreme Court upheld this law. We will continue to move forward with implementing the health exchange that will lower coverage costs for New York’s businesses and help ensure that uninsured New Yorkers have access to health care. We look forward to continuing to work together with the Obama administration to ensure accessible, quality care for all New Yorkers.”
12:30 p.m. update:
Healthcare Association of New York State President Daniel Sisto indicated that the state’s hospitals and health-care systems are pleased with the results of the decision.
“Insurance will be made more affordable, particularly for those with pre-existing conditions, among others who had been effectively shut out of the health-insurance marketplace,” he said in a news release.
“This decision will also continue to spur health-care providers to reduce health-care costs and improve patient care through innovations in the way health-care is provided,” he continued. “We already see hospitals and other health-care providers in New York making these kinds of changes, even as they face repeated, deep cuts in reimbursement from Medicare and Medicaid.”
The human-resources consulting firm Mercer pointed out that the court’s ruling means employers will need to work to comply with the reform law if they want to avoid penalties. Mercer, which has 20,000 employees in over 40 countries, covers all of New York State north of Westchester County in its upstate region. It has an office in Rochester.
“The Supreme Court’s ruling removes a major source of uncertainty surrounding this important national issue,” Mercer President and CEO Julio A. Portalatin said in a release. “With all of the law’s provisions still in place, employers will need to redouble their compliance efforts, especially regarding such immediate requirements as providing summaries of benefits and coverage to their employees. This decision also reinforces the continuation of such popular features as coverage of dependents up to 26 and elimination of preexisting-condition exclusions.”
The National Federation of Independent Business (NFIB) called the affirmation of the individual mandate a “deep disappointment to small businesses everywhere.”
“The tragedy in this ruling is that New York residents are now at the mercy of politicians from other states and bureaucrats in Washington whose decisions won’t be based on what is best for New York,” NFIB New York State Director Mike Durant said in a news release. “Small businesses here will be overwhelmed by mandates, taxes, and burdens imposed on them by people whom we cannot as easily hold accountable.”
11:37 a.m. post:
New York Attorney General Schneiderman, who filed a brief in support of the law, offered the following in a news release:
“The Supreme Court’s decision to uphold the Affordable Care Act is an historic victory for the tens of millions more Americans who will be covered by health insurance. The law’s effects will be significant in our state, where over 2 million people are uninsured. Over a million uninsured New Yorkers will soon have access to affordable coverage. This law will continue to provide a spectrum of key consumer protections including keeping young adults on their parents’ plans, ending pre-existing condition restrictions, and increasing consumer information about health care choices. My office stands ready to enforce the Affordable Care Act to ensure that all New Yorkers will benefit from the law’s protections.”
U.S. Sen. Kirsten Gillibrand (D-N.Y.) provided this statement:
“I am pleased the Supreme Court reaffirmed the hard fought progress that was made to ensure that no one can be denied coverage for a pre-existing condition, being a woman will no longer be a pre-existing condition, young adults will be covered, prescription drug costs for seniors will be reduced, preventive care including life-saving mammograms will be accessible and that insurance companies can’t cancel their coverage when you get sick. It is time to get beyond scoring political points and get back to finding common core values and passing legislation that will help grow our economy and get more people back to work.”
U.S. Rep. Ann Marie Buerkle (R-Onondaga) also commented.
“Today, the Supreme Court ruled to uphold the majority of President Obama’s health-care law,” Buerkle said in a release. “Throughout this entire process my concern has always been to ensure that all Americans have access to quality, affordable health care and that the sanctity of the doctor/patient relationship is upheld. I have spent most of my professional life in health care, first as a nurse and later as a health-care attorney. I understand how important of an issue this is for all Americans. I am currently reviewing the Supreme Court decision in its entirety to determine its impact on the people, hospitals, and businesses in my district.”
The Tompkins County Chamber of Commerce released a statement focusing on portions of the Affordable Care Act that establish tax credits for small businesses and state health-insurance exchanges. The chamber said it supports New York’s creation of a Small Business Health Options Program (SHOP), a portion of the state’s under-construction insurance exchange that will give employers a place to shop for insurance for their employees.
“Along with the creation of the SHOP Exchange to make it easier for small businesses to compare and enroll in health plans and programs, continued implementation of the [Affordable Care Act] will increase the tax credits available to small employers to 50 percent of their health-insurance premium costs in 2014,” the chamber said in its statement. “The Tompkins County Chamber of Commerce continues to connect small businesses to health-insurance options, supports the establishment of the SHOP, and helps employers obtain access to health-insurance tax credits throughout our region.”
The Business Council of New York State, Inc. said in a news release that the Supreme Court’s decision will do little to change the health-insurance issues the state’s employers face.
“Employers struggle with high group-coverage costs, high state-imposed taxes and surcharges, and an ever-expanding list of coverage mandates,” The Business Council President and CEO Heather Briccetti said. “Nothing in today’s ruling helps ‘bend the cost curve’ or addresses the issues driving health-care costs and utilization in New York State, which make the state one of the most expensive health-insurance markets in the nation and a tremendous burden on large and small employers.”
Briccetti also commented on the development of New York’s health-insurance exchanges.
“The Business Council will continue to address key health-care reform issues,” she said. “As an example, we will work to [ensure] that New York’s health exchange development will have full and transparent stakeholder participation. Insurers, agents, brokers, chambers of commerce, and employers must be involved in all stages of [development] of the exchange to ensure that New York will have as robust a health-insurance market and health-care delivery system as possible given today’s decision.”
Contact Seltzer at rseltzer@cnybj.com