Health Care Debate Continues Beyond Upcoming Supreme Court Ruling

by May 21, 2012

WASHINGTON (NNPA) – Even if the Affordable Care Act survives U.S. Supreme Court scrutiny, a favorable ruling this summer will not serve as a cure-all for insuring African Americans, according to health professionals and a report in the current issue of Health Affairs. Healthcare advocates still have to deal with the consequences of November’s presidential election – especially if President Obama is defeated – even if “we win everything in June,” said Mara Youdelman, managing attorney in the Washington, D.C. office of the National Health Program, a nonprofit that advocates for the health rights of low and underserved people.

She made that observation at last month’s National Minority Quality Forum in the nation’s capital. During a panel discussion on “ACA in the Balance: Do We Need a Plan B,” Youdelman said that the next obstacle could be getting Congress to spend discretionary funds to support the United States Department of Health and Human Services efforts. “We have to get Congress to actually say, ‘We’re going to spend money for the workforce provisions and funding for HHS to have the staff to move forward to implement everything they need to implement, to monitor and new oversight to make sure everything’s done right,’” she said.

“So regardless of what the Supreme Court does, we almost need a Plan B as well. We need to make sure that we are able to move forward effectively, efficiently and with the provisions that we want to see happen so that we are addressing disparities.” After hearing oral arguments in March, the deeply-divided Supreme Court is weighing whether the law’s requirement that most Americans have health insurance is constitutional, and if not, how much of the law to invalidate. A decision is expected to handed down in June. On a Supreme Court that often decides major cases by a 5-4 margin, five of the justices were appointed by Republican presidents and four were appointed by Democrats. A Washington Post-ABC News poll last month found that most people believe the Supreme Court justices will vote along partisan political lines rather than solely on the merits of the case. Half of those polled said they expected them reflect their “partisan political views.”

Less than 40 percent expect the decision to be made “on the basis of the law.” The remainder did not express an opinion or expect the ruling with be a combination of politics and merit. Fredette West, executive director of the African American Health Alliance, said she plans to focus on Plan A – getting the health care law upheld rather than looking for a fallback plan. “Fight for plan A. Don’t let go. Do not let go. If they can take that from you, they can take anything they want from you,” West said.

“If I can jeopardize your health, I can do anything under the sun to you.” The Health Affairs report, titled “The Affordable Care Act’s Coverage Expansions Will Reduce Differences in Uninsurance Rates by Race and Ethnicity,” is one of the first studies that examined effects of the legislation along racial lines. It said 21.6 percent of African-Americans are without health insurance, compared with 13.9 percent of Whites and 33.3 percent of Latinos. Today, 50.3 million Americans are uninsured, a figure that is projected to drop to 26.4 million if the Affordable Care Act goes into effect. Medicaid and the Children’s Health Insurance Program (CHIP) coverage will account for “disproportionately large gains in coverage” among Blacks. An 8.4 percent increase is expected in coverage of Blacks by these two programs, rising to 36.5 percent. “Those eligible for Medicaid and CHIP, but who remain unenrolled, constitute the single largest group, at 35.7 percent,” according to the Health Affairs study, authored by Lisa Clemans-Cope, Genevieve M. Kenney, Matthew Buettgens, Caitlin Carroll and Frederic Blavin.

“This eligible-but-unenrolled group includes 58.8 percent of the blacks who we estimate will remain uninsured under the Affordable Care Act, which is a higher proportion than found in the other racial and ethnic groups examined.” Dr. Willarda V. Edwards, an internal medicine physician in Baltimore and past president of the National Medical Association (NMA), acknowledges the progress that has been made under health care reform. “We definitely don’t need a Plan B. If the Supreme Court doesn’t come down with a favorable decision, we know that we have at least gotten everyone at the table,” she said. “All the health professionals have been talking about the need for changing the healthcare system that we have.” •

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