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Administration to approve generic versions of the
complex and often expensive drugs known as
biologics and imposed a 10 percent tax on tanning
salons — all relatively minor provisions that could be
accomplished through legislation.
But others were more pessimistic, noting that
Congress is so mired in election-year politics that even
such seemingly benign measures could be blocked.
And there is little hope that Congress could devise an
alternative to the law anytime soon. “If this law is
completely thrown out, a lot of momentum to solve
some of these problems is going to be vitiated,” said
Helen Darling, the chief executive of the National
Business Group on Health, which represents
employers that offer health benefits.
How much the states could continue on their own is
unclear. “In this political environment, it’s going to be
exceedingly difficult,” said Mike Kreidler, the insurance
commissioner for Washington State, who supports the
law.
Some states like California and Maryland have made
progress in creating the exchanges, where people will
be able to more easily shop for policies. But many
questioned whether most states would be able to
proceed without federal funding.
“There might be some states that will go forward, but it
will be a crazy-quilt pattern,” said Ron Pollack,
executive director of Families USA, a consumer group
that supported the health care law. (He is no relation to
Ms. Pollack, the retail association official.)
Both insurers and employers predicted that most
The New York Times/ - Politics, Sáb, 31 de Março de 2012
CLIPPING INTERNACIONAL (Supreme Court)
insurance companies would continue popular policies
that were enacted under the law. Insurers have
already factored in the costs of allowing adults under
26 to be covered on their parents’ plans and
eliminating co-payments on preventive services, and
companies are also unlikely to reimpose lifetime limits
on coverage. “It’s more trouble to roll it back,” said Mr.
Laszewski, the health care consultant. “It’s part of the
market now.”
Other provisions in the law tried to experiment with
changes to how doctors and hospitals are paid,
moving away from the current system in which they
make more by performing more tests and procedures
to rewarding them more for delivering better care that
saves money by keeping patients out of the hospital
and emergency room.
But much of the ability of hospitals to change how they
care for patients, even as government programs like
Medicare and Medicaid pay them less, was dependent
on the tens of millions of new paying customers, said
Len M. Nichols, a health economist at George Mason
University who supports the law. “Everybody thought it
would buy them time to become as efficient as they
need to be,” he said.
Still many hospital executives and insurers say big
changes in how care is being delivered will continue
regardless of the law. “It’s been our experience and
observation that the health care system has been
undergoing reform for some time before this debate
and this bill of 2010,” said Richard J. Umbdenstock,
head of the American Hospital Association. “We’re
already making dramatic course changes.”
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