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Clock ticking as Supreme Court weighs healthcare law

The U.S. Supreme Court’s current session ends in June and sometime before that it will issue a ruling that will accent the divide in the country over the Affordable Health Care Act.

Tri-State Defender Staff and wire reports

The U.S. Supreme Court’s current session ends in June and sometime before that it will issue a ruling that will accent the divide in the country over the Affordable Health Care Act.

Three days of review of what many critics derisively call “Obamacare” were completed on Wednesday. High-profile lawyers positioned themselves before the High Court and debated whether the entire law should be junked if the individual mandate, which requires that almost all Americans buy health insurance or pay a penalty, is ruled unconstitutional. They jousted over whether the government’s plan to expand Medicaid violates basic tenets of federalism.

In Memphis and in cities and towns throughout the country, people on both sides of the issue checked news flashes for tidbits and updates. For three days it became fashionable to listen to newsmen and newswomen speculate on what questions – and even gestures – by the justices might ultimately mean relative to a decision.

Many are predicting a close decision given the overall makeup of the court.

The implications for private citizens, businesses, churches and medical facilities can hardly be overstated.

“I’ll leave the legalities to be decided by the Supreme Court, but President Obama’s plan has the intention of broadening access to quality healthcare,” said Dr. Reginald W. Coopwood, president and CEO of The Regional Medical Center at Memphis.

“It would expand medical insurance coverage to everyone. And I truly believe that had we not worked to improve our quality of care, we wouldn’t be so well positioned to benefit from the plan. We’ll continue to work toward making The Med the hospital of choice for the insured.”

On Wednesday, Rep. Steve Cohen of Memphis spoke on the House floor to urge the justices to uphold the Affordable Care Act. He noted a report issued this week that says in Memphis African-American women are twice as likely to die of breast cancer as Caucasian women.

“And that is unacceptable. Part of that is because they don’t get the health care they need, and the Affordable Care Act will see to it that everybody gets access to affordable health care,” said Cohen.

“If the Affordable Health Care Act passes, that disparity in health between white women and black women  in my city and in America will end.”

Republicans say the law puts individual freedoms “at stake.” They also point to the impact on state budgets. On Monday, Tennessee Sen. Lamar Alexander joined two other senators who, like him, are former governors, to discuss the health-care law’s impact on state budgets, particularly the impact the Medicaid expansion would have.

Service Employees International Union Healthcare Chair Dr. L. Toni Lewis had a different take.

 “Instead of refiguring the budget to give the wealthiest one percent trillions of dollars in tax breaks by cutting Medicaid and Medicare for our families, lawmakers should protect our healthcare.” Lewis said in a statement.

“The Supreme Court should do the same by dismissing politically-motivated arguments and instead upholding the new law that expands Medicaid to many more Americans who really need it.”

Meanwhile, the Whitehouse took to the Internet to humanize its position. At Whitehouse.gov, the story of Vanessa Mishkit, a nurse in Tampa, was featured with the intro that she knows firsthand what it’s like to go up against insurance companies on behalf of her child.

Mishkit’s son was born with birth defects: developmentally delayed, legally blind, and near deaf. She had health insurance through work at Tampa General Hospital, but still she was constantly fighting for her son’s coverage because he was born with a pre-existing condition.

“I had what I thought was excellent health insurance, and then after David was born we received notification that he had met his million-dollar limit and he wouldn’t be eligible for coverage,” Mishkit says in the video.

 “There are thousands and thousands of families” who are in similar situations, she says. “They can’t advocate for themselves at this time because they’re caught up in day-to-day survival.”

The Whitehouse pitch points out that the Affordable Care Act is designed to prevent insurance companies from denying coverage to children with pre-existing conditions and it includes an invitation for those with stories such as Miskit’s to share them at Healthcare.gov/MyCare.

Now it’s up to the justices of the Supreme Court to make sense of what they heard argued over the three days and match it to their understanding of the Constitution. The exchanges they will weigh this one between Donald B. Verrilli, Jr., Esq., Solicitor General, Department of Justice, and Chief Justice John Roberts.

General Verrilli: ... In the health care market – the health care market is characterized by the fact that aside from the few groups that Congress chose to exempt from the minimum coverage requirement – those who for religious reasons don’t participate, those who are incarcerated, Indian tribes – virtually everybody else is either in that market or will be in that market, and the distinguishing feature of that is that they cannot – people cannot generally control when they enter that market or what they need when they enter that market.

Chief Justice Roberts: Well, the same, it seems to me, would be true, say, for the market in emergency services: police, fire, ambulance, roadside assistance, whatever.

You don’t know when you’re going to need it; you’re not sure that you will. But the same is true for health care. You don’t know if you’re going to need a heart transplant or if you ever will. So, there’s a market there. In some extent, we all participate in it.

So, can the government require you to buy a cell phone because that would facilitate responding when you need emergency services? You can just dial 911 no matter where you are?

General Verrilli: No, Mr. Chief Justice. think that’s different. It’s – we – I don’t think we think of that as a market. This is a market. This is market regulation. And, in addition, you have a situation in this market not only where people enter involuntarily as to when they enter and won’t be able to control what they need when they enter, but when they…

Chief Justice Roberts: It seems to me that’s the same as in my hypothetical. You don’t know when you’re going to need police assistance. You can’t predict the extent to emergency response that you’ll need, but when you do — and the government provides it. I thought that was an important part of your argument, that when you need health care, the government will make sure you get it.


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