Supporters' Reactions to Supreme Court Ruling on the Affordable Care Act, June 28, 2012

The White House
Remarks by the President on Supreme Court Ruling on the Affordable Care Act

East Room

12:15 P.M. EDT

THE PRESIDENT:  Good afternoon.  Earlier today, the Supreme Court upheld the constitutionality of the Affordable Care Act -- the name of the health care reform we passed two years ago.  In doing so, they've reaffirmed a fundamental principle that here in America -- in the wealthiest nation on Earth – no illness or accident should lead to any family’s financial ruin. 

I know there will be a lot of discussion today about the politics of all this, about who won and who lost.  That’s how these things tend to be viewed here in Washington.  But that discussion completely misses the point.  Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.

And because this law has a direct impact on so many Americans, I want to take this opportunity to talk about exactly what it means for you. 

First, if you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance -- this law will only make it more secure and more affordable.  Insurance companies can no longer impose lifetime limits on the amount of care you receive.  They can no longer discriminate against children with preexisting conditions.  They can no longer drop your coverage if you get sick.  They can no longer jack up your premiums without reason.  They are required to provide free preventive care like check-ups and mammograms -- a provision that's already helped 54 million Americans with private insurance.  And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care. 

There’s more.  Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent's health care plans -- a provision that's already helped 6 million young Americans.  And because of the Affordable Care Act, seniors receive a discount on their prescription drugs -- a discount that's already saved more than 5 million seniors on Medicare about $600 each.

All of this is happening because of the Affordable Care Act. These provisions provide common-sense protections for middle class families, and they enjoy broad popular support.  And thanks to today’s decision, all of these benefits and protections will continue for Americans who already have health insurance.   

Now, if you’re one of the 30 million Americans who don’t yet have health insurance, starting in 2014 this law will offer you an array of quality, affordable, private health insurance plans to choose from.  Each state will take the lead in designing their own menu of options, and if states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too.  And I’ve asked Congress to help speed up that process, and give states this flexibility in year one. 

Once states set up these health insurance marketplaces, known as exchanges, insurance companies will no longer be able to discriminate against any American with a preexisting health condition.  They won’t be able to charge you more just because you’re a woman.  They won’t be able to bill you into bankruptcy. If you’re sick, you’ll finally have the same chance to get quality, affordable health care as everyone else.  And if you can’t afford the premiums, you'll receive a credit that helps pay for it. 

Today, the Supreme Court also upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance.  This is important for two reasons. 

First, when uninsured people who can afford coverage get sick, and show up at the emergency room for care, the rest of us end up paying for their care in the form of higher premiums. 

And second, if you ask insurance companies to cover people with preexisting conditions, but don’t require people who can afford it to buy their own insurance, some folks might wait until they’re sick to buy the care they need -- which would also drive up everybody else’s premiums.

That’s why, even though I knew it wouldn’t be politically popular, and resisted the idea when I ran for this office, we ultimately included a provision in the Affordable Care Act that people who can afford to buy health insurance should take the responsibility to do so.  In fact, this idea has enjoyed support from members of both parties, including the current Republican nominee for President.

Still, I know the debate over this law has been divisive.  I respect the very real concerns that millions of Americans have shared.  And I know a lot of coverage through this health care debate has focused on what it means politically. 

Well, it should be pretty clear by now that I didn’t do this because it was good politics.  I did it because I believed it was good for the country.  I did it because I believed it was good for the American people.

There’s a framed letter that hangs in my office right now.  It was sent to me during the health care debate by a woman named Natoma Canfield.  For years and years, Natoma did everything right.  She bought health insurance.  She paid her premiums on time.  But 18 years ago, Natoma was diagnosed with cancer.  And even though she’d been cancer-free for more than a decade, her insurance company kept jacking up her rates, year after year.  And despite her desire to keep her coverage -- despite her fears that she would get sick again -- she had to surrender her health insurance, and was forced to hang her fortunes on chance. 

I carried Natoma’s story with me every day of the fight to pass this law.  It reminded me of all the Americans, all across the country, who have had to worry not only about getting sick, but about the cost of getting well. 

Natoma is well today.  And because of this law, there are other Americans -- other sons and daughters, brothers and sisters, fathers and mothers -- who will not have to hang their fortunes on chance.  These are the Americans for whom we passed this law. 

The highest Court in the land has now spoken.  We will continue to implement this law.  And we'll work together to improve on it where we can.  But what we won’t do -- what the country can’t afford to do -- is refight the political battles of two years ago, or go back to the way things were. 

With today’s announcement, it’s time for us to move forward -- to implement and, where necessary, improve on this law.  And now is the time to keep our focus on the most urgent challenge of our time:  putting people back to work, paying down our debt, and building an economy where people can have confidence that if they work hard, they can get ahead. 

But today, I’m as confident as ever that when we look back five years from now, or 10 years from now, or 20 years from now, we’ll be better off because we had the courage to pass this law and keep moving forward. 

Thank you.  God bless you, and God bless America.

END               
12:23 P.M. EDT

Health Care for America Now
HCAN: States Should Fulfill Their Responsibilities and Fully Implement Medicaid Expansion

Washington, DC – Here is a statement on today’s Supreme Court ruling from Ethan Rome, executive director of Health Care for America Now, which ran a $53 million grassroots and media campaign to pass the Affordable Care Act:

“Today, the Supreme Court ruled that the debate over the Affordable Care Act is over. Obamacare is here to stay. The days of health insurance company price-gouging and denials of care are over.

“Every family and small-business owner who worries about health care and their future can breathe a sigh of relief.

“This ruling clears the way to move full steam ahead on implementing Obamacare. The court has spoken, and the constitutional debate is done. This ruling tells every anti-Obamacare Republican governor it’s time to move forward with full implementation and end the political nonsense.

“Thanks to this law, working and middle-class families will have financial and health security. Millions of Americans will gain insurance coverage for the first time, joining the more than 100 million who are already benefiting from the law’s consumer protections and benefits.

“We are disappointed that the decision weakens the federal government’s power to enforce the Medicaid expansion. Under the court’s ruling, some states may choose to exclude the lowest-income uninsured adults from their Medicaid programs. We will organize at the grassroots level in state capitals to make sure this does not happen. Fortunately, other provisions of the law will help this population get the care they need.

“Now that the Republican-dominated corporate court has upheld this law, it’s appalling that the GOP has already said it wants to continue this debate in Congress and take away your health care by repealing the law. The Republicans have already pledged to continue their relentless campaign to undermine the health care security of America’s families. They want to end Medicare as we know it, dismantle Medicaid and repeal Obamacare, including the ban on discriminating against people with pre-existing conditions. ”

The ACA already benefits more than 100 million people, including seniors, small business owners and workers, women and children. In 18 months, even more benefits will be available, including elimination of pre-existing condition exclusions for adults, the opening of health insurance exchanges enabling families and small businesses to get the best possible deal on comprehensive health plans, and expansion of Medicaid eligibility in every state. HHS has announced that consumers and businesses will collect $1.1 billion in rebates from health insurers that overcharged their customers.

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Health Care for America Now is the nation’s leading grassroots health care advocacy organization. HCAN led the fight to win passage of health reform and to keep Congress from being steamrolled by corporate special interests.
Families USA
Huge Victory for American Families as Supreme Court Validates Health Reform

Today the U.S. Supreme Court ruled that the Affordable Care Act’s individual mandate and Medicaid expansion are constitutional, thereby allowing health reform to move forward. The following is the statement of Ron Pollack, Executive Director of Families USA, about this development: 

“Today’s Supreme Court ruling is a clear, unambiguous, and complete victory for long-overdue health care reform. It sends an unmistakable message that the building of a better, fairer health care system will continue to move forward.

“Implementing health reform will provide peace of mind for our families, the peace of mind that comes only when our loved ones are sure to receive the health care they need when they need it.

“The Affordable Care Act provides such peace of mind by ensuring that:

No one will be denied health coverage or charged a discriminatory premium due to a pre-existing condition, such as children with asthma or diabetes;

People with major health problems, like those in car accidents, will be protected against arbitrary lifetime or annual limits in how much insurance companies will pay for needed care;

“It has taken close to a century to enact meaningful health reform. Now that the Supreme Court has upheld the law, it will become a living reality for all Americans very soon.”

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Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans.

Service Empoyees International Union
Republican Leaders Must Respect Supreme Court Decision to Uphold Affordable Care Act
Americans Want Our Country to Move Forward

Washington, DC - SEIU President Mary Kay Henry issued this statement in response to House Republican plans to hold a vote to repeal the Affordable Care Act during the week of July 9.

"Earlier today, the Supreme Court upheld the Affordable Care Act as fully constitutional, including expansion of care to 32 million Americans, a range of consumer protections from insurance company abuses, the creation of competitive marketplaces in states for individuals to purchase lower cost insurance and quality of care improvements.

"The United States Supreme Court has spoken: the Affordable Care Act is constitutional. For more than two years, extremists in Congress have teamed with insurance companies and corporations to spend millions to undermine the law and play politics with the health of Americans.

"If Speaker Boehner, Congressman Paul Ryan and Mitt Romney respect the Supreme Court and the Constitution of the United States and care about the health and financial security of millions of Americans, this must stop. Now is the time to put Americans and the future of our country first and focus on creating the kind of good jobs our country needs."

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With 2.1 million members in Canada, the United States and Puerto Rico, SEIU is the fastest-growing union in the Americas. Focused on uniting workers in healthcare, public services and property services, SEIU members are winning better wages, healthcare and more secure jobs for our communities, while uniting their strength with their counterparts around the world to help ensure that workers--not just corporations and CEOs--benefit from today's global economy. www.seiu.org

AFL-CIO
Statement by AFL-CIO President Richard Trumka on the Supreme Court Health Care Decision

We are pleased and relieved that the Supreme Court has upheld the constitutionality of the Affordable Care Act.  Today’s decision means that we can continue moving full speed ahead to implement and build upon the Affordable Care Act.  We have no illusion that the destination has been reached, and we are more committed than ever to the hard work necessary to achieve our dream of quality health care for all. 

With this decision, more than 105 million Americans will continue to benefit from the elimination of lifetime limits and the coverage of preventive services without cost-sharing, and more than 6 million young adults will remain covered by their parents’ health care plans.  Seniors will continue to save money on prescription drugs as the Part D donut hole closes over the next eight years; already over 5 million seniors have saved $3.7 billion on prescriptions in 2010 and 2011.  And insurance companies will not be able to deny coverage due to pre-existing conditions, charge women more or drop coverage for those who get sick.

To assure that 33 million Americans will be able to obtain health care coverage through the exchanges and Medicaid beginning in 2014, all states, including those that waited for this decision to be issued, must now do their job and act without delay.  We are troubled by the Court’s decision limiting the ability of the federal government to encourage states to extend Medicaid coverage to certain lower income individuals, and it would be unconscionable for states to refuse to extend that coverage, using today’s decision as a pretext.

The Affordable Care Act is our first step in expanding health care coverage, improving care and beginning to get control of health care costs.  We will need to build on the achievements of the Act, Medicare and Medicaid in order to fix our broken health care system and advance along the path to a more equitable and cost-effective system. 

We believe the way forward is to build on the Affordable Care Act reforms that strengthen Medicare’s historic leadership in containing health care costs, without cutting benefits.  A simple indisputably constitutional solution is to allow Americans of all ages to buy into an improved Medicare program.  We believe every baby in America—whether rich or poor—deserves the same standard of quality care, and we will keep moving forward until we make this a reality.

We cannot afford to go backward, but that is what Mitt Romney and the Republican leadership in Congress would do.  Their prescriptions would not expand coverage or control health care costs.  Instead, they would shift costs to working families, retirees and the states. 

The election this November provides a clear choice between the President, who has stood for fairness and for working men and women, and Romney, who urges repealing health insurance protection for working families. We stand with the President.

Center on Budget and Policy Priorities

Statement of Robert Greenstein, President: Court Decision Will Allow Health Reform to Bring Major Benefits to the Nation, Especially If States Do Their Job

Today’s Supreme Court decision allows the nation to reap the very substantial benefits of the Affordable Care Act:  health insurance coverage for millions of uninsured Americans, important consumer protections for millions of insured Americans whose coverage has serious gaps, and the promise of progress in slowing the growth of health care costs.

States and the federal government should move forward immediately to get ready for 2014, when the law’s major coverage expansions are scheduled to take effect.  State and federal policymakers should prepare to launch health insurance exchanges and to enroll millions of people in Medicaid beginning in January 2014.

These efforts still face significant challenges — including a major new challenge as a result of one aspect of the court decision, as explained below.  For both states and the federal government, much work lies ahead to establish health insurance exchanges, set up enrollment processes that work smoothly both for the exchanges and Medicaid, and complete other critical tasks by the 2014 deadline.  The timeframe is short, particularly in states that have made little progress since the law’s passage. 

The Biggest Challenge

The single biggest challenge may lie in the decisions that states make regarding health coverage for uninsured people living below the poverty line — primarily working-poor parents and other adults who work for low wages.  The Affordable Care Act made those people eligible for Medicaid, but the court decision appears to make the law’s requirement that states expand Medicaid to cover all individuals up to 133 percent of the poverty line essentially a state option.

A state would have little basis for refusing to implement the Medicaid expansion, other than for narrow ideological reasons.  The Affordable Care Act provides 100 percent federal funding for the expansion for its first three years, phasing down after that to 90 percent federal funding.  And the expansion, by greatly reducing the number of uninsured, will enable states and localities to save substantial sums on uncompensated care for the uninsured.  (A new Center blog post examines this issue in more detail.) 

But in any state that does refuse to implement the expansion, a shocking inequity will arise.  People with incomes between 100 percent and 400 percent of the poverty line will be eligible for subsidies to help them afford coverage in the new health insurance exchanges.  But people below the poverty line will not be eligible, because the Affordable Care Act assumes they’ll be in Medicaid instead.

In the typical (or median) state today, a working-poor parent loses eligibility for Medicaid when his or her income reaches 63 percent of the poverty line; an unemployed parent loses eligibility at just 37 percent of the poverty line.  In states that refuse to implement the Medicaid expansion, people with incomes between levels such as these and the poverty line will be ineligible for both Medicaid and subsidies to purchase coverage in the exchanges; their incomes will be too high for the former and too low for the latter.  It will be up to state policymakers to avert such a deeply inequitable outcome by moving forward with the Medicaid expansion.

Court Decision Allows Key Advances Under Health Reform to Continue

As a result of the decision, a number of important consumer protections and benefit improvements will remain in place, and others will take effect in 2014 as scheduled.  The Affordable Care Act already bars insurers from imposing “lifetime limits” on benefits, meaning that insurance companies can’t cut off care for people with costly medical conditions.  Also, insurers may not deny coverage to children with pre-existing health conditions like cancer, autism, or diabetes, and this rule will apply to adults, as well, starting in 2014.  Insurers also won’t be able to charge higher premiums to women or sicker people and will face restrictions on their ability to charge older people more.

With the law in place, prescription drugs will continue to be more affordable for many seniors and people with disabilities.  Health reform has already begun providing discounts to close the “doughnut hole,” the gap in Medicare prescription drug coverage that many seniors experienced once their annual drug costs exceeded $2,930.  The discounts will increase each year until the law closes the entire doughnut hole by 2020.

The court decision also means that the Affordable Care Act’s initiatives to begin slowing the growth in health care costs across the economy can continue.  Rising health care costs are putting pressure on the budgets of families, businesses, and public programs like Medicare and Medicaid.  Health reform makes progress in this critical area by instituting various cost-sharing measures and taking a number of steps to identify and implement changes in health care delivery that can lower costs while improving the quality of care.

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The Center on Budget and Policy Priorities is a nonprofit, nonpartisan research organization and policy institute that conducts research and analysis on a range of government policies and programs. It is supported primarily by foundation grants.

American Nurses Association
ANA Lauds Supreme Court Decision Upholding Health Care Reform Law

SILVER SPRING, MD – The American Nurses Association (ANA) lauds the U.S. Supreme Court’s decision today to uphold the Affordable Care Act (ACA), including the “minimum coverage provision,” hailing it as a victory for all patients and their families. This is particularly true for those 50 million adults and children who currently lack adequate health coverage. ANA praises the law’s consumer protections and the opportunity it opens for registered nurses (RNs) to assume an even greater role in providing high-quality, cost-effective care.

“This decision means that millions of people will have access to the basic health care and preventive services that they’ve lacked,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “Instead of getting sicker and developing serious and costly complications because they can’t afford to manage their health conditions, people will get the care they need to recognize problems earlier or avoid them altogether. There will be savings throughout the system.

“Registered nurses are well-positioned to lead in providing essential prevention and wellness services and care coordination for individuals and families,” Daley added. “The law enhances opportunities for nurse practitioners and nurse midwives to provide primary care. This will increase accessibility for the growing number of people needing basic health services.”

ANA has been a steadfast supporter of the 2010 health care reform law and its provisions to expand access to health care; protect consumers; improve the quality of care; emphasize primary care, care coordination, disease management, and prevention; increase community-based care; and utilize nurses to their fullest capabilities, as leaders and essential members of multi-disciplinary health care teams.

Alarmed by the growing numbers of uninsured individuals and families, rising costs, and quality of care concerns, ANA has advocated for health care reform since 1991’s Nursing’s Agenda for Health Care Reform, most recently updated in 2008. As guiding principles, ANA contends that health care is a basic human right, and that all deserve access to essential health care services.

In January, ANA joined other health care groups in filing an amicus brief with the Supreme Court supporting the ACA’s minimum coverage provision, or “individual mandate,” that requires nearly all Americans to carry health insurance or pay a tax penalty. ANA contends that the provision is needed to spread risks and costs fairly and reduce uncompensated care expenses.

ANA also views the decision as a win for all consumers due to the law’s protections against certain insurance industry practices, such as denying coverage because of pre-existing health conditions and imposing annual or lifetime coverage caps.

For RNs, the ACA creates more opportunities to lead or participate in innovative, team-based care delivery models, such as accountable care organizations and medical homes, with incentives for nurses’ expertise in care coordination. The law also provides funding to expand nurse-managed health centers and for nursing education and workforce development.
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ANA is the only full-service professional organization representing the interests of the nation's 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.
National Latina Institute for Reproductive Health

Supreme Court Decision Means Health Care Access for Latinas

“Latinas have historically faced a disproportionate number of barriers to basic health care, and we can now envision a future where those barriers begin to crumble,” said NLIRH executive director Jessica González-Rojas. “Everyone has a fundamental right to quality, affordable health care. Today’s Supreme Court decision is an important step toward making that right a reality.”

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The National Latina Institute for Reproductive Health is the only national organization working on behalf of the reproductive health and justice of the 20 million Latinas, their families and communities in the United States through public education, community mobilization and policy advocacy.