What now for health care, federal power?
Here's a roundup of editorial excepts regarding the Supreme Court ruling on the Affordable Care Act:
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The United States is a step closer to joining the rest of the developed world in making health care accessible to most or all citizens, thanks to Thursday's welcome ruling by the U.S. Supreme Court. And in writing the opinion, Chief Justice John Roberts took a step toward restoring the integrity of the nation's highest court, which, until this case, was looking more and more like an arm of the Republican Party.
SAN JOSE MERCURY NEWS
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Regardless of the paths taken to get there, the court reached the right results. The individual mandate is a crucial part of the effort to make coverage available to more people by barring insurers from denying coverage to or gouging people with preexisting conditions. The Medicaid expansion also brings coverage to a huge number of the uninsured. And reducing the number of uninsured, in turn, helps the efforts to slow the growth of health care costs by enabling more people to get preventive care, manage chronic ailments more efficiently and reduce the demand for high-cost emergency room services.
LOS ANGELES TIMES
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The law is now real. It has transcended the convoluted political rhetoric that somehow convinced a majority of Americans that the individual mandate (an idea that originated with the conservative Heritage Foundation) was a bad thing, even while most of its individual components were good things. Now the debate turns seriously to the states, where lawmakers must decide whether to devise their own insurance exchanges or let the federal government do it for them.
ST. LOUIS POST-DISPATCH
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While the court upheld the individual mandate in the Affordable Care Act (ACA), it also knocked down a hugely significant provision of the law. Democrats may have been so giddy over what happened Thursday 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, it could lose all of its federal Medicaid funds.
That, wrote Roberts, "is economic dragooning that leaves the states with no real option but to acquiesce in the Medicaid expansion."
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.
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.
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The court changed the national discussion with its decision to uphold most of the ACA. Time and energy spent debating medical-insurance coverage must now focus not only on providing care but also on 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.
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.
U.S. corporations and manufacturers compete in a global business environment against companies with virtually no health care overhead. The Affordable Care Act offers some relief.
Knee-jerk threats to dismantle the law need to be challenged with a single question: How will the outraged, arm-waving politician provide health care for 30 million uninsured Americans?
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It may not have been his intention -- in fact, we're pretty confident that it wasn't -- but in providing the deciding vote, Roberts has saved millions of Americans from dying before their time.
Thursday's decision doesn't eliminate the very real threat to democracy posed by the Supreme Court's radical lurch to the right. But for millions of Americans whose access to affordable health care is more secure, it was a day to celebrate.
PHILADELPHIA DAILY NEWS
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In the end, it was a defining characteristic of government -- the power to tax -- that saved the ACA's constitutional bacon in the Supreme Court. That and Roberts' disinclination to overturn from the bench the historic votes on the House and Senate floors that extended health insurance coverage to nearly all Americans.
Assuming a President Romney doesn't take office in January with enough support to overturn the law, no longer will the United States remain just about the only advanced country lacking universal coverage. No longer will the worst aspects of our often-outstanding health care system work against us, bankrupting some unfortunate people who are badly hurt or fall seriously ill.
No longer will children in families that make too much to qualify for existing Medicaid but too little to afford private insurance go uncovered in the face of unaffordable medical costs. No longer will "preexisting" ills disqualify people from coverage. No longer will those who lose or change their jobs -- and employer-provided health insurance -- be left out in the cold. Real, tangible benefits will reach tens of millions more Americans.
RALEIGH NEWS & OBSERVER