by Ed Lallo/Newsroom Ink
In one of the most highly anticipated high-court rulings, the U.S. Supreme Court upheld in a 5-4 decision the controversial Affordable Health Care Act, better known as Obamacare. The ruling will have a direct effect on indigent and working poor health care in Austin and Central Texas, as well as possibly influence the success or failure of a proposed medical school to be located in Austin.
The high court ruled that Congress was acting within its powers under the Constitution when it required most Americans to carry health insurance or pay a penalty—the provision at the center of the two-year legal battle.
“The passage of health care reform marked a significant step towards better care for all Americans,” said Jesús Garza, interim executive director for the Seton Healthcare Family. “The law is not perfect, but it is a step in the right direction that encourages us to build on ways to make health care better, more affordable, more accessible and person-centered.”
With more than 25% of the state’s population uninsured, Texas has the highest percentage of residents in the U.S. not covered by health insurance. Seton has maintained health care will be reformed community by community.
Central Texas has the opportunity to dramatically improve health care locally by building a medical school at UT Austin and a new teaching hospital to replace UMC Brackenridge, according to Garza. In his opinion the newly proposed University of Texas medical center, which Seton is a major supporter, is now more important than ever with the passage of this bill.
With the expansion of the residency programs the medical center it will offer, he believes doctors that train here will stay here, and this bill would provide patients the opportunity to be seen in ambulatory setting as opposed to an acute case setting.
In an opinion by Chief Justice John Roberts, the Affordable Health Care Law was upheld as a tax. The justices found fault with the health-care law’s expansion of Medicaid, a joint federal-state insurance program for the poor, and made adjustments to portion of the law.
“There are expressed concerned about the Medicare reimbursement rate,” Garza explained. “but the first step in providing Medicare coverage is to use the political process to ensure those programs are funded adequately so doctors can continue to provide services for those in need.”
Seton Healthcare Family, a member of Ascension Health, is a supporter of the expansion of Medicaid and is currently reviewing the decision for clarification on Medicaid expansion penalties to make healthcare more accessible and affordable for all, including the poor and vulnerable.
The high courts upholding of the individual mandate is essentially the funding behind the legislations, a major victory for President Obama.
Chief Justice John Roberts was the swing vote in the decision joining Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan.
“This legislation will benefit doctors who are continually under the challenge of seeing patients in the office, or treating in them in hospitals, without any kind of insurance coverage,” explained Garza. “Their practices when confronted with those realities suffer in the sense that they don’t get paid. In the care reimbursement we have in place now for indigent care, there is no reimbursement. Nobody gets paid for that, there just has never been any reimbursement.”
Gazaa is anticipating less use of the emergency room as an urgent and primary care facility as people have access doctors as primary care providers.
“When the ill appear in an emergency room because they have delayed need attention and are extremely sick, they end up in a hospital or an intensive care unit for weeks at a time because they failed to have access to coverage, medicine and medical attention needed,” he said. “The new law will give people an insurance product to give them access to preventive medical care for themselves and their families.”
In a Twitter post after the ruling, Nancy Pelosi, the Minority Leader of the United States House of Representatives said, “Victory for the American people! Millions of American families and children will have certainty of health care benefits + affordable care.”
“The new law is not just about coverage; it was is a wakeup call for the entire health care industry,” said the interim director of the Seton, a member of the largest U.S. Catholic hospital system. “How can you organize that care differently, how can you put people at the center of the system, as opposed to a hospital system, as opposed to doctors at the center, as opposed to nurse at the center, put the people at the center.”
According to Garza, the central Texas working poor are the real beneficiaries of the new law; those people that really make the Austin and central Texas economy hum.
“These people work 8-5, and often overtime. You have to offer these individuals an alternative of hours when they can be treated,” he said. “We have to change the system to Saturdays, Sundays and evenings so they can access care for their children, their spouses or themselves. And then let see how we can organize the care so it can be delivered in a way we can be proud of.”