By Deborah Sederberg
A local physician is grateful to U.S. Supreme Court Chief Justice John Roberts for breathing the breath of life into the the Affordable Care Act (ACA).
"Chief Justice Roberts made the difference between life and death for the (ACA)," said Vidya Kora, who, through physicians organizations, including the Indiana State Medical Association and the American Medical Association, for years has been speaking about and working for a health care plan to cover a nation in which nearly 50 million Americans are uninsured.
Roberts broke with the other four conservative justices, Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas. He voted instead with the four traditionally liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor. What's more, the Chief Justice wrote the majority opinion.
Roberts has ties to Indiana, and more specifically La Porte County. He attended Notre Dame Elementary School and graduated from La Lumiere High School.
ACA is not perfect, said Kora, who has served as president of ISMA.
But he is pleased that under ACA, children can be covered by their parents' insurance until age 26.
He is also pleased to see that people with pre-existing conditions in the future will be able to purchase insurance.
He does wish that the act had addressed an effort to reduce the cost of health care, such as malpractice reform.
Kora would have addressed the conscience issues differently. Church employers (churches employ ministers, secretaries, deacons, for example) are exempt from the act's requirement to provide insurance coverage for birth control, sterilization and abortions, Kora explained. But according to HHS, church-affiliated employers, such as universities and hospitals, enjoy no such exemptions. Kora has written to the U.S. Secretary of Health and Human Services Kathleen Sebelius to express his support for exemptions for church-affiliated employers.
Kora believes the ACA will be tweaked and changed before most of it goes into effect in 2014. "We have time to work with it and tweak it," he said.
Thor Thordarson, president and chief exeutive officer of IU Heath La Porte Hospital, said, "IU Health has been making contingency plans" based on several scenarios for some time. Executives looked at how their organization would respond if the court were to strike down the act and how they would respond if only certain parts of it were deemed unconstitutional.
"At least we know now," he said. "It's constitutional." Like Kora, he said medical facilities need to take a serious look at cutting costs, while keeping patient welfare at the forefront of all decisions..
Franciscan St. Anthony Health responded through its corporate offices, Franciscan Alliance. "We support the response of the National Council of Catholic Bishops," a spokesman for Franciscan Alliance said.
In its response, the bishops noted that "for nearly a century, the Catholic bishops of the U.S. have been and continue to be consistent advocates for comprehensive health care reform to ensure access to life-affirming health care for all, especially the poorest and most vulnerable."
The bishops are critical of ACA because it would use federal funds to pay for elective abortions and for plans that cover abortions. The bishops also object to what they see as the act's failure to recognize an employer's rights of conscience.
The Act also "fails to treat immigrant workers and their families fairly," the bishops said.
Despite the Act's flaws, the bishops said, "The (conference of bishops) has not joined in efforts to repeal the law in its entirety and we do not do so today. The decision of the Supreme Court neither diminishes the moral imperative to ensure decent health care for all nor eliminates the need to correct the fundamental flaws described above."
The bishops continue to "urge Congress to pass and the Administration to sign legislation to fix those flaws."
"I'm surprised by the ruling," said Gene Diamond, chief executive officer of Franciscan Alliance, Northern Indiana (which includes Franciscan St. Anthony Michigan City). "It's a fairly complex decision. It's going to take some time to understand exactly what the Court said and what it means, but it's clear the law is constitutional."
Other comments on ACA:
* U.S. Senator Dick Lugar, R-Indiana who voted against ACA "at every step of its legislative consideration," expressed his disappointment at the Supreme Court decision. He cited his concern about "trillions of dollars of new spending, billions in new taxes and failure to control the rapid increase in health care costs."
* U.S. Senator Dan Coats, R-Indiana, called ACA "an unpopular, massive intrusion of the federal government into the individual lives of Americans."
* Jackie Walorski, Indiana Second Congressional District Republican candidate, said, "President Obama's health care law stands to be the single largest tax increase in our nation's history, paid for by working class families across the country."
* Indiana Chamber of Commerce President and CEO Kevin Brinegar said, "Our concern is the impact the health care law will have on Hoosier businesses and their workers. Mandating coverage for pre-existing conditions and extending coverage for dependent children to age 26 will cause increases in health care costs; there is no way around it."
* First District Congressman Pete Visclosky said, "The Supreme Court's decision to uphold the Affordable Care Act is a victory for the millions of Americans whose lives will be improved. Because of the Affordable Care Act, children can no longer be discriminated against by insurance companies, millions of seniors will be better able to afford prescription medication, and in the future, individuals with pre-existing conditions cannot be denied coverage."