U-Michigan experts respond to U.S. Supreme Court health care reform

"The decision was good news for consumers and the health care system. The affordable Care Act establishes comprehensive insurance market reforms that will guarantee access to health care and protect Americans from catastrophic medical costs."
-- Tom Buchmueller, the Waldo O. Hildebrand Professor of Risk Management and Insurance at the Ross School of Business.
-------------------
"I’m extremely pleased that the Supreme Court decided that millions of Americans will now have access to health care to allow them to become healthier."
-- Mark Fendrick, professor in the department of Internal Medicine and Health Management and Policy and co-director of the U-M Center for Value-Based Insurance Design.

-------------------
"The Affordable Care Act is not a perfect law. But it is so much better than what we have without it. The court’s decision and careful deliberation affirms that our form of government works, balancing competing views in a fair and thoughtful manner. It is, indeed, a remarkable day in health care."
-- Marianne Udow-Phillips, lecturer at the U-M School of Public Health and director of the Center for Healthcare Research & Transformation, a nonprofit partnership between the U-M Health System and Blue Cross Blue Shield of Michigan.
--------------------
"I’m delighted and relieved by the Supreme Court decision. We shouldn’t and don’t let the uninsured die on street. People who can do so must contribute to the possible future expense of their care."
-- Susan Dorr Goold, medical ethicist, professor of internal medicine and health management and policy.
-------------------
"I applaud the Supreme Court’s decision. Now let’s get on with the important work of covering the uninsured and ensuring that health spending is on a sustainable path."
-- Helen Levy, a research associate professor at the Gerald R. Ford School of Public Policy, as well as at Institute for Social Research and the Department of Health Management and Policy in the School of Public Health.

LAW

"I am sorry that the Court did not adopt what I would have thought to be an obvious proposition - that because it has asserted since McCulloch v. Maryland in 1819 that in regulating commerce Congress may use any means it deems appropriate and that is not otherwise unconstitutional, Congress may, if it deems it appropriate in regulating commerce, require individuals to buy a good or service (a type of mandate that states may unquestionably impose and that Congress may in other contexts).

"But what’s the damage? As I understand the chief’s opinion, it only limits Congress from requiring under the commerce power, that individuals purchase designated goods or services. And, as he says, Congress has never done so before. I didn’t think the fact that it never did so before was a strong argument - it’s never felt the need to do so, and may not again. But I suppose that if Congress does want people to buy broccoli, it can now impose a tax on those who fail to buy it."
-- Richard Friedman, the Alene and Allan F. Smith Professor of Law at U-M Law School.
--------------------
"The Court’s decision to uphold the individual mandate is a big win for the Affordable Care Act and the Obama Administration. But the Court’s Medicaid holding threatens to undermine the part of the Act that was expected to provide coverage for more than 15 million individuals. And, by holding for the first time ever that a conditional federal spending program unconstitutionally coerces the states, the Court has created the prospect of a wave of new litigation challenging the conditions on cooperative federal-state programs in education, civil rights, and other areas."
-- Samuel Bagenstos, professor at the U-M Law School.
--------------------
"What’s the legal effect of the decision? Although it was the focus of all the pre-opinion debate, the Commerce Clause analysis may well be dictum. The health care effect? It remains to be seen how many states now scramble to get their exchanges up and running."
-- Jill Horwitz, professor of law at U-M Law School and professor of Health Policy and Management in the U-M School of Public Health and Gerald R. Ford School of Public Policy.

POLITICS

"The Supreme Court decision today was a significant victory for the Democratic health care policy, but the Republicans and Mitt Romney will use it to energize their base in this fall’s campaigns. The Court did not help the Democrats by accepting their third argument for constitutionality - that it was a permissible tax passed by the Congress."
-- Michael Traugott, professor of communication studies and senior research scientist at the Institute for Social Research’s Center for Political Studies.
--------------------
"Cutting in his favor: The ruling allows Obama to claim that the Affordable Care Act was a success and it was one of the major accomplishments of his first term in office. The Supreme Court’s decision psychologically validates the law, even though, technically speaking, the ruling applies only to the law’s constitutionality, not to its substantive merits. Importantly, today’s ruling gives the president a renewed opportunity to explain to the public why the Act is important and how it will improve health care, since he failed to effectively project his message on these points when the Act was initially being debated in Congress.

"Cutting against him: The ruling raises the salience of what is already a highly unpopular piece of legislation that has damaged the president’s public standing. It will likely galvanize the conservative grassroots to actively support Republican nominee Mitt Romney, which they have been loathe to do up to this point."
-- Michael Heaney, assistant professor of organizational studies and political science.