NASE News

Supreme Court Considers Health Care Reform

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By Kristie L. Arslan

In an unprecedented 5 ½ hours of oral questioning, the Supreme Court recently heard the challenge to President Obama’s biggest legislative accomplishment in his presidency, the Patient Protection and Affordable Care Act.

The court pondered four key health care reform questions:

1. The legality of the individual mandate
2. Whether a tax can be reviewed by the court before it takes effect
3. Whether the individual mandate can be severed from the rest of the reform law
4. The legality of the Medicaid expansion

The court’s review of the law happened just as a public poll by CBS and The New York Times showed that  nearly 47 percent of Americans disapprove of the health care law, specifically the individual mandate, and that two-thirds of Americans would like to see some or all of the law overturned.

However, there is broad support, 85 percent, for some of the key market reforms such as requiring insurance companies to cover people with pre-existing medical conditions and allowing adults to remain on their parents’ insurance until age 26.

The NASE continues to oppose the individual mandate. The lack of cost controlling mechanisms in the law along with the mandate put America’s smallest businesses in the difficult position of being required by law to purchase more expensive health coverage.

In this difficult economic time, forcing small businesses to pay for costly health insurance without providing them with an affordable coverage option is too great a burden.

The association is supportive of the market reforms included in the law. But the NASE believes that Congress failed to address underlying issues of affordability when crafting the health care law.

Affordability of health care remains the NASE’s top legislative priority. We believe strongly that if the Supreme Court strikes down the health care law in its entirety or just the individual mandate, that Congress should commit itself to working across the aisle to put forth common sense solutions that allow for a competitive health care market.

This market would let individuals pick and choose health coverage options based on their health needs with quality, affordable health plans in the mix for those with budget constraints. To that point, the NASE has actively pursued Congress to enact legislation that would allow for the permanent deduction of health care insurance for the self-employed, one of the easiest and quickest ways to bring equity to the health care market and lower costs.

Additionally, key reforms in health reimbursement accounts that would allow employers to reimburse employees for related health care costs is another way that tools already in the market can be used to address coverage and affordability issues.

Kristie L. Arslan is president and CEO of the NASE and provides critical insight to policymakers on issues affecting our nation’s self-employed. You can contact her at advocacy@NASE.org.