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Business Insurance/ - Article, Seg, 02 de Abril de 2012
CLIPPING INTERNACIONAL (Supreme Court)
Individual mandate rejection seen as
worst legal outcome
WASHINGTON—Deciding that the individual mandate
in the health care reform law is unconstitutional while
keeping the rest of the law intact would be the
“worst-case scenario” of possible Supreme Court
actions on the law, most industry experts agree.
“It does not put us back to where we were prior to
health care reform. It puts us in a place that is much
worse than that,” said Jim Napoli, senior counsel with
Proskauer Rose L.L.P. in Washington.
Hewrote an amicus brief on behalf of the
Washington-based American Benefits Council
suggesting that the court should strike the employer
mandate if it decides the individual mandate is
unconstitutional.
“It would cause employers to seriously consider
whether to remain in the health care game” because
“for many employers, the cost of the penalty would be
less than the cost to actually provide coverage,” he
said.
Moreover, “insurers may pull out of certain markets
and not provide individual coverage. What does that
do to the group market? Or what does it do the cost of
health care in a more general sense? The employers
that self-fund will still be impacted even if they"re not
purchasing an insured product because the cost of
health care will go up. That"s the negative
consequence of it,” Mr. Napoli said.
“The insurance industry will just increase the cost for
everyone,” said Larry Boress, president and CEO of
the Midwest Business Group on Health in Chicago.
Of eight states that enacted guaranteed issue and
community rating without an individual mandate, “three
went into the ditch and only five were left standing, but
they are limping along,” said Paul Keckley, executive
director of the Deloitte Center for Health Solutions
based in Washington.
Indeed, during oral arguments, Solicitor General
Donald B. Verrilli Jr. told the court that when
community rating and guaranteed issue were
implemented in New Jersey, rates soared and the
number of individuals covered plummeted from
180,000 to 80,000. “In Kentucky, virtually every insurer
left the market,” he added.
Ed Haislmaier, senior research fellow in the Center for
Health Policy Studies at the Heritage Foundation,
predicts that if PPACA is allowed to stand without the
individual mandate “the whole thing goes south very
quickly.”
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