Moving ahead: Care providers mixed on ruling’s impact

By Michaela Gibson Morris/NEMS Daily Journal

Tupelo family physician Anne Haire caught snippets of the Supreme Court’s decision on health care reform on Thursday.
She couldn’t pause to celebrate or bemoan the constitutionality of the individual mandate to purchase insurance; she had patients to take care of in her west Tupelo office.
“It doesn’t change what I do,” Haire said. “I take care of patients.”
The Supreme Court-validated individual mandate requires most Americans to purchase health care insurance, providing subsidies through health care exchanges for people with moderate incomes and penalties for those who don’t buy. It requires employers with more than 50 employees to offer health insurance or face penalties.
Thursday’s decision also said the federal government can’t penalize states for opting out of expanded Medicaid coverage by withholding their current levels of funding.
Like Haire, leaders at Tupelo-based North Mississippi Health Services and Memphis-based Baptist Memorial Health Care – the two largest health care organizations in Northeast Mississippi – say their missions remain the same: Providing high-quality health care and the best possible outcomes for their patients.
“That’s why we’re here,” said North Mississippi Health Services CEO John Heer of his organization’s commitment.
Thursday’s decision will not affect the construction of a new hospital in Oxford, said Don Hutson, CEO for Baptist Memorial-North Mississippi.
But hospital leaders will be watching the debate leading up to the November elections and beyond while preparing to implement the law as it stands.
“The decision will definitely reset the discussions, but the question we must answer as a nation is how to create an affordable health care system that will be successful in the future,” said Bob Gordon, chief administrative officer for Baptist Memorial Health Care, which has hospitals in Oxford, New Albany and Booneville.
Tupelo family physician Dr. Edward Hill spent most of his tenure as American Medical Association president talking about health care reform. He has concerns about the sustainability of the Affordable Care Act, but also sees opportunities in some provisions of the law.
“I’m not taking sides … I think health care costs are an enormous unsolved issue,” Hill said. However, “health insurance exchanges could inject real competition into the health insurance market.”
Taking sides
Some health care advocates are taking positions for and against the decision.
Mississippi Medical Association President Steve Demetropoulos said the Supreme Court decision increases the chaos surrounding health care.
“Everyone is confused. Physicians see government stepping between the doctor and her patient,” said Demetropoulos in a statement, noting that the Mississippi Medical Association had recently rescinded its support of the Affordable Care Act. “Our patients wonder how they will navigate a health care system in crisis – especially when they are ill.”
The Mississippi Health Advocacy Program called the decision a “tremendous victory” for Mississippi families.
“Thousands of Mississippians have already benefited from the ACA – seniors are paying lower drug costs, young adults have been able to stay on their parents’ insurance plan, and insurance no longer has lifetime limits and covers preventive care with no out-of-pocket costs,” the Jackson-based organization said in a statement.
Medicaid expansion?
The law allows Medicaid to expand to cover families up to 133 percent of the federal poverty line; it is a key component of extending coverage among the uninsured in Mississippi – 500,000 adults and 100,000 children under current estimates.
Under the act, federal government would pay for more than 90 percent of the cost of expanding Medicaid, but that would still leave the state on the hook for hundreds of millions of dollars each year.
“If Mississippi elects not to implement wider Medicaid eligibility, then we remove Medicaid as a health insurance option for Mississippians most in need, those who have no other option for health coverage,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program, noting the guidelines would cover working families.
If states opt out of Medicaid expansion, “I don’t think we’ll see a large spike in the number of insured,” said American Health Lawyers Association president Dinetia Newman, a health care attorney who splits her time between Tupelo and Jackson.
That could produce ripple effects, Newman said.
Insurance companies may lobby for increased penalties to encourage more participation in the system in order to continue elements like guaranteed insurance for people with pre-existing conditions, Newman said.

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