This article first appeared in the St. Louis Beacon, March 19, 2012 - The U.S. Supreme Court will uphold the controversial Affordable Care Act, predicted Health and Human Services Secretary Kathleen Sebelius on Monday. She went on to promise that the federal government would set up an insurance exchange in Missouri if state lawmakers refuse to create one.
"I'm confident that the law will be found constitutional," she said Monday during a forum at St. Louis Community College at Forest Park. "A majority of (appellate court) judges have found the law constitutional. There's about 70 years of precedent where the Supreme Court has continued to uphold Congress in broadening the powers of the Ccommerce Clause, which is really what this case is about."
During the appellate hearings, she said, most "judges, Republican appointees and Democratic appointees, have found this to be a fully constitutional law."
Sebelius was also asked about the resistance in the Missouri Legislature to setting up an insurance exchange, a key component of helping residents find and buy affordable health insurance.
"I don't have a direct message for the Missouri Legislature, but I want the citizens to understand that if the state chooses not to set up a state-run exchange, we will have an exchange available for residents of Missouri. So one way or another, folk eager for affordable health-care coverage will have the benefit of the Affordable Care Act come 2014," she said.
Sebelius pointed to law's positive impact of seniors:
- offering free checkups for certain health conditions,
- closing the so-called doughnut hole to make prescription drugs more affordable,
- and charging women and men the same for similar health conditions.
For once, she jokes, being a woman no longer will be considered a pre-existing condition, allowing insurance companies to charge higher premiums to women.
Sebelius' upbeat message was in sharp contrast to complaints by groups, ranging from Tea Party activists to mainstream Republicans, that want the court to void the law. Many are arguing that ACA will add to the deficit, impose a mandate for everybody to buy health insurance or be fined, and deny patients access to the health insurance of their choice.
But Sebelius says the law would allow people to keep their existing health insurance. As for the mandate, she says, adding everyone to the insurance pool offers a way to expand health insurance for more people.
The session at Forest Park was sponsored by the Missouri Alliance for Retired Americans and was moderated by Judith Parker. The panelist includes Fritizi Lainoff, 82, of St. Louis County, who praised Medicare and the Affordable Care Act, saying both have been a lifeline for herself and her husband.
Others on the panel were Rona McNally, preject director of Care Connection for Aging Services; Carol Weidner, a St. Louis County senior who praised the value of federal efforts to close the doughnut hole; Dr. William Fogarty, a retired internist and strong proponent of the health-reform law; Mary Clemmons, a senior who praised the law for giving seniors access to certain preventive services without co-pays; and Amy DeWein, a pharmacist.
Impact of health-care reform
Sebelius stressed that many health reforms already were making a big difference. She said these included:
- Providing new coverage options to allow children under age 26 to remain on their parents' policies. This provision has helped nearly 40,000 Missouri young adults, she said.
- Making sure insurers aren't imposing unreasonable premium increases.
- Removing lifetime limits on health benefits.
- Increasing support for community health centers.
- Providing at least one preventive service without a co-pay to more than 1.6 million Missouri residents.
She added that the prescription drug legislation allowed Missouri seniors to realize an average savings of $595 and a total savings of more than $46 million to all Missouri residents in the prescription drug program.
Although Sebelius spoke about the insurance exchange system, she didn't mention the controversy involving Missouri until it was raised during the forum. Missouri has received a $1 million planning grant for its exhange, along with a $20.8 million to continue work on the program. But work has been stopped because the Republican leadership has passed a law that the Nixon administration take no action on an exchange until the Legislature pass a law for one. So far, no insurance legislation is expected to be approved in this session.
