Editorials on the Supreme Court's health-care decision

Editor’s note: The following editorial excerpts appeared in papers around the country following the U.S. Supreme Court’s ruling on the Health Care Act.

Vindication for ‘Obamacare'

The Supreme Court's ruling Thursday upholding President Obama's health-care reform law wasn't the sort of ringing pronouncement that helps define the contours of government power and individual rights for decades to come. The justices were sharply divided, and Chief Justice John G. Roberts Jr.’s controlling opinion reads like an exercise in splitting the baby. But the end result is one that Americans in general, and Californians in particular, should celebrate.

The highly polarized debate about the constitutionality of “Obamacare” was so overwrought that it obscured what the Patient Protection and Affordable Care Act actually does. Far from being a government takeover of healthcare, as its critics claim, the measure seeks to improve the current system while leaving private insurers, doctors and hospitals largely intact. Its three main, interdependent goals are to significantly reduce the number of Americans who have no health insurance, promote higher-quality care and find ways to slow the growth of health-care costs. Policymakers have little choice on the latter; out-of-control health-care spending is draining the resources of governments, employers and families across the country.

The Affordable Care Act provides just a framework for a better healthcare system, not a complete solution, and there's much work to be done. That work would have been significantly harder, though, had the four conservative dissenters on the court prevailed in their call for tossing the entire act. Granted, a new president and a new Congress could still repeal the law, which will almost certainly play a more prominent role in the November election now that the Supreme Court has let it stand. But unless and until that day comes, policymakers and healthcare leaders should continue to build on the foundation the law created for a more efficient, effective and affordable health-care system focused on keeping people healthy, not treating them when they're sick.

--Los Angeles Times

Financing Medicaid's expansion in doubt

While the U.S. Supreme Court upheld the individual mandate in the Affordable Care Act, it also knocked down a hugely significant provision of the law. Democrats may have been so giddy over what happened Thursday — “John Roberts gave us a break?!” — that the impact of this hasn't quite sunk in.

The high court said the federal government cannot compel the states to cooperate in a broad expansion of Medicaid. That was anticipated to provide health care for 16 million to 17 million people, half the people who would gain care coverage under the law.

In essence, anyone who earns up to 133 percent of the federal poverty rate would be covered. The law sought to force the states to add those people to their Medicaid rolls. If a state refused to comply, it could lose all of its federal Medicaid funds.

This is big: Twenty-six states challenged the constitutionality of the Affordable Care Act on the grounds that the individual mandate and the Medicaid requirements were unconstitutional. National health care may turn out to be not so national after all, if most or all of those states walk away. With so many states struggling to pay the cost of Medicaid now, that's a distinct possibility. ...

The enormous cost of this health care expansion, and the failure of its architects to be completely forthcoming about that cost, has been our central complaint about the law.

If Democrats want to save the ambitions of this law, they're going to have to find a way to write a Truly Affordable Care Act. That is, they're going to have to devise ways to put genuine cost containment in the bill, if they hope to keep the states on board for Medicaid expansion.

-- Chicago Tribune

Now focus on coverage and cutting costs

The U.S. Supreme Court changed the national discussion with its decision to uphold most of the Affordable Care Act. Time and energy spent debating medical-insurance coverage must now focus not only on providing care but also containing costs.

The latter is urgent because soaring health-care costs are the No. 1 threat to economic prosperity and government treasuries. The law did not address enough substantial reforms to rein them in.

Politicians on both sides of the aisle must accept the decision and move ahead. Republicans should put a lid on the prattle about repeal. President Obama and Democrats get a few scant moments of gloating about their policy triumph, then they must deliver on deeper commitments imposed by their achievement.

Broad medical coverage will benefit tens of millions of Americans. Their access to prenatal care, preventive medicine, discounted drugs and basic access to medical treatment will save money.

At the same time, the Obama administration and the infrastructure being established in states across America must find ways to rein in costs. That overhead takes many forms: the right care delivered at the right time and place, best practices within the medical profession, and the administrative overhead to provide care and deal with insurance providers.

Unchecked, higher medical costs hit taxpayers via public-employee labor and benefit contracts and state Medicaid costs for low-income people. They haunt consumers by way of costs passed on by businesses, small and large.

The Affordable Care Act is an extraordinary opportunity for the nation. Maximizing its potential requires a laser focus on managing care and cutting costs.

--Seattle Times