Published June 29, 2012
By Liv Osby, Staff Writer
Reaction in South Carolina to the U.S. Supreme Court’s ruling to uphold most of the federal health-care reform law Thursday came down largely along party lines, with opponents calling it a new tax that needs to be repealed while supporters said it’s a step toward providing health-care coverage to 30 million more Americans.
Gov. Nikki Haley said the law’s mandate requiring people to purchase health insurance or pay a penalty amounts to “one of the largest tax increases on the American people we have ever seen.” She said even though the law was upheld, “What was bad policy yesterday is bad policy today.”
U.S. Republican Sen. Jim DeMint of Greenville said the law should be repealed.
“We were told it was not a tax hike, but this ruling confirms it is an unprecedented and enormous tax on the poor and middle-class Americans,” DeMint said.
“The American people now have the chance and Congress has the responsibility to fully repeal this Washington takeover and reform health care ourselves, together, around the principles of individual liberty, not government mandates.”
Assistant Democratic Leader James E. Clyburn, D-S.C., hailed the ruling as “a big, big victory for the American people.”
“President Obama and Democrats in Congress carefully crafted this law on the basic premise that every American deserves affordable access to quality health care as a matter of right and not of privilege,” he said.
“I have said throughout this debate that this law is the Civil Rights Act of the 21st century. History will look kindly on this tremendous achievement.”
U.S. Republican Sen. Lindsey Graham said he is calling for new debate over the law because the Obama administration said it wasn’t a tax during the original debate.
“I have always believed the individual mandate would not be upheld under the Commerce Clause because you cannot compel someone to enter into commerce,” Graham said. “However, I have always been afraid the broad power to tax could be used by the court to justify Obamacare.”
Jacqueline Fox, an associate professor of law at the University of South Carolina, said the ruling was “fairly consistent with what the federal government has been doing for some time” and that the constitutionality of the law was never in question.
“It’s clearly constitutional,” she said. “And it’s a traditional area for the federal government to step in.”
The law requires that Americans buy insurance beginning in 2014 or pay a penalty. It also establishes exchanges of private insurers to make it easier to buy that coverage, with subsidies if necessary, and expansion of the Medicaid program for the needy.
It also allows young people to stay on their parents’ insurance until they are 26, provides coverage for people with pre-existing conditions, helps seniors pay for medicine that falls into the payment gap known as the donut hole, covers preventive services and eliminates the cap on insurance coverage.
House Speaker John Boehner immediately called for repealing the law in its entirety.
Republican state Attorney General Alan Wilson said the ruling carves out new taxing authority for Congress and hamstrings the state’s Medicaid program, which is set to expand under the law.
“While the court ruled today that existing federal money used to fund Medicaid cannot be cut, any new money necessary to fund this explosion of new recipients could be withheld from any state that does not fall in line with Congress’ wishes,” he said. “Many states will simply not be able to afford this new onerous mandate.”
Haley said the best thing Washington could do would be provide block grants and allow the states to decide how to spend it.
Tony Keck, director of the South Carolina Department of Health and Human Services, agreed.
“It’s an inflexible program that tries to put a one size fits all on every state. But the challenges in South Carolina are different than other states,” he said. “This decision does not give us that flexibility.”
U.S. Republican Rep. Trey Gowdy of the 4th District said the ruling empowers Congress to control behaviors through taxation.
“Can Congress tax you for not exercising enough since that impacts the cost of health care?” he asked. “It’s a sad day for those who believe in personal responsibility and a limited federal government.”
U.S. Republican Rep. Jeff Duncan of the 3rd District said the decision “strengthens my resolve to push for complete repeal.”
While some were disappointed, others were elated. Among them was Sue Berkowitz, director of the South Carolina Appleseed Legal Justice Center.
“For those who don’t have health care right now, there’s hope in sight,” she said. “And we hope that the state will do the right thing to expand Medicaid, which will be in the best interest for all in South Carolina.”
Dr. Georges C. Benjamin, executive director of the American Public Health Association, called the ruling a “significant milestone” in that will save some 44,000 people who die each year because they don’t have insurance.
And Marcia D. Greenberger, co-president of the National Women’s Law Center, said women can rest easy “that they and their families can continue to receive the many benefits of the health care law.”
Michael J. Fitzpatrick, executive director of the National Alliance on Mental Illness, said the decision means America can move toward a system that covers everyone. And Ethan Rome, executive director of Health Care for America Now, said families and small-business owners who worry about health care can breathe a sigh of relief.
“Thanks to this law, working and middle-class families will have financial and health security,” he said.
Ben Homeyer, South Carolina director of National Federation of Independent Business, said the decision will cost jobs.
“Under the health care law, small business owners are going to face an onslaught of taxes and mandates, resulting in job loss and closed businesses,” he said.
Frank Knapp, CEO of the South Carolina Small Business Chamber of Commerce, said the law has already benefited small business through health care tax credits.
“Fewer people without insurance will curtail cost-shifting that results in those with health insurance paying higher premiums,” he said, “(and) small businesses will finally be paying the same rates as big corporations.”
BlueCross BlueShield of South Carolina CEO David Pankau said the state’s largest insurer is moving toward implementing the law, but added it doesn’t address the root causes of rising health care costs.
And Karen Ignagni, CEO of the trade group America’s Health Insurance Plans, said while the law expands coverage to millions of Americans, “major provisions, such as the premium tax, will have the unintended consequences of raising costs and disrupting coverage unless they are addressed.”
Reactions in the health care community also were mixed.
American Hospital Association CEO Rich Umbdenstock said the ruling “lifts a heavy burden from millions of Americans who need access to health coverage” and gives hospitals the clarity they need to proceed toward transformation.
South Carolina Hospital Association CEO Thornton Kirby said while the constitutional issues were clarified, uncertainty about the future of health care reform wasn’t.
“The debate is now going to intensify as it moves from the courts into the political arena,” he said. “I don’t think anybody has the answer yet.”
The South Carolina Medical Association was “extremely disappointed” with the decision. President-elect Dr. Bruce Snyder said many members thought the mandate would be overturned and that the group is still concerned about funding of care.
“We need to move forward,” he said. “But we will continue to advocate for legislation to make things better in the future.”
Bon Secours St. Francis Health System’s parent company issued a statement saying it “has long supported health reform that expands access and coverage to everyone … and ongoing advocacy for those who suffer because they lack quality, compassionate health care services.”
And Greenville Hospital System CEO Michael C. Riordan said it’s too early to know all the ramifications of the ruling, “and we realize that they may not all be known for some time because of the possibility of a post-election response to the act.”
But he added, “No matter what happens over the coming months, virtually no one is predicting a return to the historic status quo.”
Spartanburg Regional Healthcare System spokesman Chad Lawson said the ruling has ended speculation about the constitutionality of the law, but that much work remains to correct the issues facing the health care industry.
AnMed Health in Anderson said that while the decision is “encouraging news for the thousands of Upstate residents who were considered uninsurable,” it expects the debate to continue leading up to the presidential election.