The healthcare industry is bracing itself, as the Supreme Court, whose final ruling will ultimately decide the constitutionality of President Obama's health reform legislation, will hear the challenge brought up by 26 states next week.
If the court upholds the law, the implementation of provisions can proceed as scheduled. But that could cause more harm than good, warns Joseph Antos, an American Enterprise Institute for Public Policy Research analyst. "In reality, many of the states, including states that really want to do it, are woefully unprepared," he told Healthcare IT News.
If the law is struck down, provisions already in effect would have to be withdrawn; for example, children would no longer be allowed to stay on their parents' insurance plan up to age 26.
The Supreme Court also must decide what happens to the rest of the health reform law if only the individual mandate is ruled unconstitutional. While opponents say the entire law should get struck down, the government maintains that only two provisions (including one requiring insurers cover people with preexisting health problems) would have to fall, according to ABC News.
Industry experts warn, though, that such a move would make the rest of the law more difficult to carry out. "Without a mandate the law is a lot less effective," MIT economist Jonathan Gruber told the Associated Press. "The market will not collapse, but it will be a ton more expensive and cover many fewer people."
Similarly, Paul Keckley, executive director of Deloitte Center for Health Solutions, said there could be mass effects on the young, newly insured. "Should the individual mandate ultimately be ruled unconstitutional, it will significantly hamper the ACA's ability to ensure some of those previously uninsured 'young invincibles,' as well as seriously undermining a key rationale for funding the new law," he said in a statement to FierceHealthcare last fall.
Despite the Supreme Court ruling, health executives at hospitals, medical groups and insurers in California said they will press on with healthcare reform, the Sacramento Business Journal reported earlier this month.
"We believe we need to drive health care reform whether it's legislated or not," Michael Taylor, Dignity Health's senior vice president of operations said. "Healthcare costs are out of control and we need to bend the curve."