The torrent of comment on the Supreme Court decision to uphold most of the Affordable Care Act fell predictably along party and ideological lines: Democrats and progressives were exulting; Republicans and conservatives were disgusted, except for the ruling that the individual mandate was a tax.
It will take several days to digest the full implications, but here are lightly edited versions of over two dozen reactions received by MarylandReporter.com. There are lots of words, some repetition, but easy to skim by source and comment.
O’Malley and Brown have led some of the most aggressive plans of any state to implement the new law. In a joint statement, they said:
“In upholding the Affordable Care Act, the U.S. Supreme Court chose to protect the lives of millions of Marylanders and millions of Americans. American businesses will be more competitive in the global economy with lower health care costs and a healthier workforce. Parents will be able to keep their children on their health care plans until age 26. Seniors will avoid the Medicare Donut Hole. And by 2014, no American will be denied health care coverage because of a pre-existing condition.
“Today’s decision gives considerable momentum to our health care reform efforts here in Maryland. What it does not – and indeed must not – do, is give us license to take our eye off the ball or slow our progress. Moms, dads, and kids throughout Maryland are counting on their elected leaders to continue the mission of lowering costs, and improving the quality of care.
U.S. Barbara Mikulski: Let’s hear it for Democracy
On the steps of the Supreme Court, Democrat Mikulski was nearly shouting. (Video of Mikulski)
“Good morning America! Good morning the world! If you wanted to know what democracy looks like, come to Constitution Avenue. This is what democracy looks like.
“The Congress voted on healthcare. The Supreme Court has ruled on healthcare. We now know that healthcare is legal, constitutional, undeniable and irreversible.
“Let’s hear it for Democracy!
“The system worked and it will work for the American people. We will now be able to go forward with making sure that 32 million people have universal access to health care insurance.
“We’ve broken the stranglehold of insurance companies where guys in pinstripes sitting in their board rooms decided who got healthcare. Now we know the people will get the healthcare they need, that their doctor says that they need, and they will be able to afford to get it.
“For we women, it’s an enormous victory. Because today, what we’ve been able to affirm is that insurance companies will no longer be able to discriminate on the basis of gender. No longer will women pay 30% more for their health care than men of the same health care status.
“Number two, simply being a woman will no longer be a pre-existing condition. We cannot be denied health care because we are pregnant, because we’ve had a C-section or because we’ve been a victim of domestic violence.
“We affirmed our preventive health care where we’ll be able to get our mammograms at no additional cost and we’ll be able to get our maternity health care.
“And as we fought for the women, we also fought for the men too.
“It’s very noisy here. It’s very exciting here. But this is the voice of democracy – open, free to all.
“God bless you. God bless America. Thank God the Supreme Court followed the Constitution.”
Mikulski remarks on the Senate floor in this video were more subdued but no less positive.
GOP Chairman Alex Mooney: Voter should change poor political choices
Today is undoubtedly a very difficult day for all of us. Many of us hoped mightily that our Supreme Court would recognize that Barack Obama, Nancy Pelosi, and Ben Cardin misled the American people when they pledged not to raise taxes on the middle class. In the Obamacare decision, the Court affirmed that Obama, Pelosi, and Cardin voted to raise taxes on all Americans at a time when we’re losing our homes, our jobs, and our belief in America’s future.
It is true that the Supreme Court’s role is not to save us from poor political choices. Like it or not, we as Americans elected the current occupants of every position from the White House to Government House. We are represented by the likes of Donna Edwards, and Steny Hoyer in the House of Representatives. Despite the desire of most Americans for healthcare to be between themselves and their doctors, these members not only voted to insert the federal government between doctors and patients, but also to raise taxes on those who refuse to comply.
In the Senate, our state is represented by Ben Cardin and Barbara Mikulski–two native Baltimoreans. When they were born, Baltimore was one of the wealthiest and most prominent cities in our Nation. Today, after decades of Cardin and Mikulski in office, Baltimore is now known for crime, decline, and corruption.
This is why we must not let ourselves be dismayed by today’s events. We must remember that true political power does not exist in the halls of Congress, or the chamber of the Supreme Court. True political power is in our hands and it’s up to us to use it.
U.S. Sen. Ben Cardin: Best possible decision
Democrat Cardin today called the Supreme Court’s decision on the Affordable Care Act “the best possible decision for the American people, because everyone now will have access to affordable, quality care and will be protected against the abusive practices of insurance companies.”
“Upholding the Affordable Care Act, in its entirety, was the right decision under the law for the Supreme Court. I thank the justices for setting aside the politics surrounding this debate and actually following precedent and the law. (Cardin’s office declined to revise the statement when it was pointed out the Medicaid mandate for expanded coverage by the states was found unconstitutional.)
“The Supreme Court’s decision is a win for the American people and the future of our health care system. The Affordable Care Act will extend coverage to 32 million Americans who are now uninsured; it will guarantee strong patient protections for all; it will improve Medicare coverage for nearly 50 million seniors; and it will reduce the nation’s deficit by $230 billion over the next decade. Before this law, every responsible American with health insurance was subsidizing the health care needs of the rest. That unfair arrangement will be coming to an end soon, as all Americans become part of a more efficient, more cost-effective health care system.”
U.S. Senate nominee Dan Bongino, Cardin’s Republican opponent: Liberty sold out
“Your liberty and freedom were sold out today to a now boundless government, free to dictate your healthcare choices. Now, more than ever, is the time to elect new leaders to the Senate who believe that we are entitled to a citizen-centric government, not a mandate that citizens center their lives on government.”
Republicans in House of Delegates: Repeal the tax
“Obviously, the Supreme Court’s ruling is disappointing”, said House Minority Leader Anthony O’Donnell. “But, it is important to remember the Supreme Court upheld the individual mandate as a tax – something that President Obama has repeatedly denied. Today is the day when work to repeal this tax begins in earnest.”
“The cost of ACA is staggering”, said House Minority Whip Jeannie Haddaway-Riccio. “It is not just limited to the federal government either; state budgets could take a massive hit. The one bright spot in this ruling is that states cannot be forced to expand their Medicaid programs. Of course, with Governor O’Malley’s rush to be one of the first states to enact Obamacare, Maryland’s budget may not benefit from this ruling.”
Congressional Budget Office (CBO) estimates that the ACA will increase the federal debt by over $500 billion in 10 years. When the federal government starts to reduce their share of the subsidies in 2019, Maryland’s already-strained budget will explode.
“In the worst economy in 80 years, with thousands of people out of work, the costs of this bill will mean higher taxes for everyone”, said O’Donnell. “With the burden this will put on our state and federal budgets, you will pay higher taxes even if you buy health insurance. Our citizens’ only hope now is for a change in the White House this fall so this tax can be repealed.”
Rep. Steny Hoyer, U.S. House Minority Leader: A victory for all Americans
“Our highest court has weighed in, and its decision is a victory for all Americans who have ever worried about being able to access or afford the care they need. Democrats are proud to have worked hard to pass this landmark legislation in 2010 and of our efforts to make sure it is implemented in a way that continues to yield new benefits for patients, employers, and care providers.
“The Affordable Care Act made it illegal for insurance companies to discriminate against patients on the basis of pre-existing conditions, which has already benefitted nearly 1,000 Marylanders. The law has benefitted 46,000 young adults in Maryland who have gained coverage on their parents’ plans until age 26. The Medicare Part D ‘donut hole’ is closing, saving Maryland residents over $53 million on their prescription drugs, and over 550,000 seniors on Medicare benefitted from free preventive services, like mammograms and colonoscopies last year alone. Maryland has received $5 million to fight unreasonable premium increases, and over 140,000 Marylanders with private insurance coverage will receive nearly $28 million in rebates from insurance companies this summer. Moreover, the Affordable Care Act provides deficit savings of more than $1 trillion over the next two decades.
“This decision ensures the Affordable Care Act will remain in place and that the time for litigation and partisan posturing on this issue ought to come to an end. We must now work together to implement the Affordable Care Act in order to make care affordable and accessible to Americans.”
Tony O’Donnell, Hoyer’s GOP opponent: False claims by Hoyer
“It is important to note that the Supreme Court has said that the individual mandate imposes a tax on Americans. That is a direct contradiction to Steny Hoyer’s position that the law did not contain a tax. Obamacare is still a disaster for working families, so it is even more important to replace those who made it happen, like Steny Hoyer.”
“Hoyer falsely claimed on the floor of the House that:
- Obamacare would cut the deficit – instead, the deficit ballooned.
- We could keep our insurance – instead, many companies have dropped all insurance.
- Obamacare would reduce cost of our insurance – instead, it has gone up.
- Obamacare would protect Medicare – instead, they took $500 billion from Medicare.
“Now it is up to Congress to repeal Obamacare before it can do any more harm to the economy by implementing new taxes and burdensome regulations. Unless Obamacare is repealed immediately, millions of American families will lose their current healthcare coverage and will be forced into new government-run healthcare programs.
“Unfortunately Steny Hoyer has been in Congress for 31 years and is the individual chiefly responsible for rounding up the votes for passing the government takeover of our healthcare. Hoyer will not repeal this disastrous law he wrote.
“It’s time to take measured, bi-partisan steps and use market forces to drive down costs, increase access and take the government out of the doctor-patient relationship.”
Rep. Dutch Ruppersberger, D-2nd: Many benefits to Marylanders already
“This ruling is not about a victory for Democrats or a loss for Republicans. It’s about providing all Americans with access to quality, affordable healthcare. We’ve already seen many of the benefits here in Maryland that can now continue:
- Maryland’s seniors each saved an average of $724 on prescription drugs so far this year.
- More than 800 small businesses have gotten tax breaks to offer health benefits.
- Almost 900 people in Maryland have been added to a federally backed program that insures those with pre-existing conditions.
- About 180,000 people in Maryland have gained insurance through the private exchange.
- 1.2 million Marylanders received at least one free preventive service through their private insurance.
- 52,000 young adults in Maryland have chosen to stay on their parents’ policies.
The idea behind the individual mandate is to be responsible for your own health needs instead of burdening others, to make it easier for those who can’t afford insurance to find options in the private market and to help employers offer health benefits to workers. The Supreme Court has spoken and we now need to work together to implement the law of the land and achieve these goals.”
Sen. Nancy Jacobs, Ruppersberger’s GOP challenger: Another massive tax bill
“Time and time again we were told that the Affordable Care Act (ACA) would not be a tax increase. However, today’s Supreme Court ruling told us what we already knew; the ACA is another massive tax bill being pushed on middle class Americans.
“When Dutch Ruppersberger voted for this bill and openly supported it he was not only supporting massive tax increases but also more job killing regulations and mandates. Dutch Ruppersberger has solidified himself as another tax and spend congressman.
“I do not support this tax increase and think it is insulting to the people of Maryland’s 2nd Congressional district that Congressman Ruppersberger is hailing this ruling as a victory. When taxes increase and jobs are lost, nobody wins.
“One thing is clear; Every American deserves to receive high-quality care that is affordable, effective, and available. The ACA tax is not the solution.
“It will be one of my priorities to repeal these tax increases on the middle class when elected to Congress and replace them with common sense reforms.”
Del. Michael Smigiel, via Twitter: We’re all less free
“Thanks to SCOTUS, we are all less free today than we were yesterday and than we will be tomorrow.”
Del. Heather Mizeur: Doing a victory dance
“Health care should be a right and not a privilege; and thankfully, the Supreme Court agrees. I just finished doing a victory dance around my office at news of this positive ruling. I hope you are celebrating, too!”
“Maryland is a leader in implementing the new health reform law. We are creating “one stop shop” health insurance exchanges to offer Marylanders a range of affordable coverage options. We are poised to expand coverage to our state’s most vulnerable children, seniors, and low-income residents by 2014. And this month, similar to a reform rule I proposed in Maryland, insurers across the country must spend 80 cents of every dollar on health care. Insurers are now forbidden from spending unlimited amounts of your premium dollars on costs like CEO salaries and denials of your claims. As a result of this progressive policy, 140,000 Marylanders will soon receive rebate checks averaging $340 per family.”
“By 2020, when health reform is fully implemented in Maryland, we are projected to cut the number of uninsured in half and save the state $850 million in health costs.”
Vincent DeMarco, president of Health Care For All! Coalition: Fully implement this historic life-saving measure
“Marylanders and all Americans are the big winners today . Millions of Americans have already benefited from the law allowing young people to stay on their parents’ health insurance, helping small businesses afford health care, and helping seniors afford prescription drugs. In a few years, the Affordable Care Act will expand health care coverage to tens of millions of Americans, including hundreds of thousands of Marylanders, and make health care more affordable for all of us.
“We at the Maryland Health Care for All! Coalition look forward to working closely with the O’Malley Brown Administration to build upon the tremendous success we have already made here at home to fully implement this historic life saving measure in our state.”
Maryland Public Policy Institute: Ideas that don’t work
“The Obama Administration and, by extension, Gov. O’Malley’s administration, may have won in court today, but the loss was for the American people,” said Maryland Public Policy Institute president Christopher Summers. “The court may have deemed the law constitutional, but it creates a variety of health care policies that do nothing to control health care costs for Marylanders. The state has devoted significant resources in this area and will soon find that these efforts will have little effect in helping Maryland citizens.”
“The policies adopted by the O’Malley Administration will not improve access to care or reduce health care costs,” said Marc Kilmer, a Maryland Public Policy Institute senior fellow in health care policy. “Maryland has already tried the model laid out by ACA – impose more regulations, restrict consumer choice even further, spend more money on government programs. These ideas simply do not work. The state should look at adopting laws and regulations that would put consumers in charge of their health care dollars and allow providers to offer innovative products and services to meet Marylanders’ health care needs.”
Progressive Maryland, Executive Director Kate Planco Waybright: Opponents should stop wasting time
“Today, the Supreme Court ended the debate over the Affordable Care Act and ruled conclusively that Obamacare is here to stay. It’s time for opponents to stop wasting time and get to work on fully implementing the law in Maryland.
“The court has spoken and the constitutional debate is done. The law is two years old and implementation is moving forward. Over 100 million Americans already receive benefits under the law and in the next two years, the rest of America’s families and businesses can look forward to consumer relief and new benefits under the ACA that will finally give Marylanders financial and health security.
“The law stops insurance companies from denying our care and jacking up our rates whenever they please. It also ends insurance company practices that have cut short countless lives, denied coverage and services to millions and imposed billions of dollars in excess costs on consumers and employers. It also expands coverage to millions of families and small businesses who could never afford it before while at the same time lowering costs for the millions more who already have insurance.
“The law’s political opponents in Congress who have vowed to continue their efforts to undermine and repeal Obamacare should heed the court’s decision and abide by the law just like everyone else. Rather than focusing on circumventing the court’s decision with their budget that not only takes away key parts of the ACA, but also ends Medicare as we know it and dismantles Medicaid, they ought to get to work on improving the economy and creating jobs.”
Rep. Chris Van Hollen, D-8th: Huge victory changes the course of health care
“Today’s decision is a huge victory for the American people. The historic Affordable Care Act has changed the course of health care in our nation for the better, and will continue to improve the quality of life for all Americans as it is fully phased in. Ensuring that people can’t be denied care or dropped from their coverage because they have a pre-existing condition; lowering health costs; refusing to force seniors to choose between lifesaving medicine or heating for their homes; expanding access to affordable care; and putting Americans – not insurance companies – in charge of their health care choices – that is what the Affordable Care Act means for our nation.”
(Van Hollen’s Republican opponent oddly put out a statement on a talk he will give about Iran on Friday.)
Del. Sam Arora, D-Montgomery: Law reduces fear of financial devastation
“No longer must any American fear that he or she is one accident or illness away from bankruptcy. While some will focus on the political fallout, the most important result cannot be overlooked.”
“The decision is better than historic, it is caring. People now can get the care they need without the fear of financial devastation.”
Americans for Prosperity, State Director Dave Schwartz: Unaffordable, irresponsible, unaccountable
“The Maryland chapter of Americans for Prosperity is deeply disappointed by the Supreme Court’s decision to uphold a law that most Americans believed to be unconstitutional. Marylanders want real health care reform that gives them control of their personal health decisions — not unelected bureaucrats in Washington. It is no surprise most Americans are worried that this law will result in higher costs, fewer choices, and worse care for them and their families. And for good reason – they’re right.
“This law is unaffordable, irresponsible, and unaccountable; it is not hard to understand that adding $1.15 trillion in new Washington spending will not control health care costs. The country simply can’t afford this law – we have no money. The first step to enacting sustainable reform is by drafting an affordable law. Why is it so hard for Washington to understand that?
“The simple truth is the Court got it wrong, and now Congress must step in. If Congress doesn’t, Marylanders and Americans alike will be condemned to higher health care costs, a lower quality of care, and a new massive Washington bureaucracy.
“AFP will be launching a major campaign shortly telling Congress to repeal President Obama’s deeply flawed health care plan and give Americans what they deserve: health care freedom and choice – not more restrictions and irresponsible spending.”
Maryland Democratic Party Chair Yvette Lewis: Romney has no plan to replace it
“In a tremendous victory for the American people and President Obama, the Supreme Court today confirmed that health care is a fundamental right, not a privilege. The Court’s decision ensures that insurance companies will not be allowed to discriminate based on preexisting conditions; 3.1 million young people can remain on their parents’ health plan; and 33 million uninsured Americans will find affordable coverage.
“Mitt Romney may promise to ‘repeal and replace’ the Affordable Care Act, but he really doesn’t have a plan to do anything on health care. President Obama understood that health care reform was the right thing to do. It was the right thing to do to give seniors discounts on their prescription drugs, provide tax credits for small businesses and working families, strengthen Medicare and lower the deficit. Marylanders and the American people understand we don’t need to refight this battle over health care and that we’re not going to make progress by going backward. We need to move forward.”
Advocates for Children and Youth, Leigh Stevenson Cobb: Key benefits for children
“This victory for health reform is a victory for all Maryland’s children and families. All children need access to health services in order to grow and thrive”.
“The ruling allows Maryland to continue its work in setting up the Maryland Health Benefit Exchange, a transparent health care marketplace that will allow individuals and small businesses to compare ‘apples to apples’ and receive tax credits to help pay for good value health insurance coverage.”
The ACA includes provisions that translate into key benefits for children and families such as:
• Current coverage for children with pre-existing conditions such as asthma, diabetes or any other medical challenges; pre-existing condition exclusions will be banned for parents and other adults starting in 2014
• Free preventive services, including vaccinations for children
• Elimination of annual and lifetime caps or dollar limits which will facilitate continuous treatment for chronic and long-term illnesses
• Continued support for the Child Health Insurance Program (CHIP), known as MCHP in Maryland
• Rebates for families if their insurance carrier does not invest at least 80% of the paid premiums on medical care
Rep. John Sarbanes, D-3rd: Law puts patients and doctors back in charge
“All Americans deserve access to affordable, high-quality health care. The Supreme Court’s decision to uphold the Affordable Care Act (ACA) means we can continue implementing reforms that put patients and their doctors back in charge of health care decisions.
“The health reform law is reining in insurance industry abuses and enhancing benefits. Insurance companies are now prohibited from dropping patients when they get sick, placing lifetime limits on the amount of coverage a patient may receive, and discriminating against children with pre-existing conditions. Insurance companies are also required to invest a reasonable amount of the premiums they collect in better health services and more access to care – not sink it in slick advertising and excessive executive pay.
“Although I disagree with the majority’s interpretation that the Congress cannot enact an individual mandate of health insurance coverage under the Commerce Clause of the Constitution, I am pleased that we are now able to move forward.”
Rep. Andy Harris, M.D., R-1st: Repeal Obamacare and replace it with common-sense, step-by-step reforms
“While I am disappointed by the Court’s decision, I respect its authority to determine these matters. The Supreme Court’s decision determined the law’s constitutionality, not whether the law is good policy. Americans have already made up their mind on that issue. A majority favor repealing the law. As a policy, the president’s health care law is making things worse by driving up health costs, restricting access to physicians, and making it harder for small businesses to hire workers. The only way to change this is by repealing Obamacare in its entirety. Today’s decision does not change the overwhelming opposition of the American public to Obamacare.”
UPDATE ADDED Wendy Rosen, Harris’s Democratic opponent
“While no bill is perfect, this law will accomplish so much good. I applaud the Supreme Court for their ruling in this case.”
“Andy has always been out of touch with the needs of his constituents. His stance on healthcare, women’s rights, and the Chesapeake Bay has consistently shown that his allegiance is to an extremist and partisan ideology rather than to the needs of the voters. What’s more, this decision shows that his opposition to the ACA on constitutional grounds is completely bogus. This was never about constitutionality for Congressman Harris; it was about political ideology and protecting his friends in the health insurance lobby.”
“There is a lot of good in the Affordable Care Act and I will work to see that those reforms remain in place. There is still so much work to do, though, and further legislation is needed to make sure that everyone has access to care.”
Rep. Elijah Cummings, D-7th: Significant benefits for his constituents
“The impact of this decision is particularly significant for my constituents in Maryland’s 7th Congressional District. The Affordable Care Act has allowed 6,900 young adults to stay on their parents’ health insurance and made preventive services available at no charge to nearly 150,000 children and adults. Now, as a result of today’s verdict, my constituents will benefit from additional ACA benefits:
• By 2014, health insurers will be prohibited from discriminating against all adults and children with pre-existing conditions, which will protect the 110,000 to 290,000 individuals in the district with a pre-existing health condition.
• The 18,000 residents who now lack health insurance will receive coverage for the first time.
• The 430,000 residents with private insurance coverage will no longer face annual limits on coverage.
• People who buy their health insurance on the private market will be able to shop for health insurance in transparent and competitive marketplaces called exchanges, where insurers will be required to publish the prices and benefits of their policies in simple, plain language.
“The Supreme Court’s action today has very real implications for Americans across the country, making this a victory for us all.”
Frank Mirabile, Cummings’s GOP opponent (on Facebook): Forced to buy a product
“Today we have crossed a line in the history of freedom…you are now forced by the government to buy a product or be taxed/fined and risk your personal property be confiscated by the elected to give to others after they skim off the top for themselves. We have but one chance left to bring freedom back online. Financially support, volunteer, make calls and get into the faces of those who want to tax your last cell.”
Rep. Roscoe Bartlett, R-6th: This is like Dred Scott decision
“All that is legal is not moral. This same Supreme Court at a different time in history and different justices handed down the Dred Scott decision. I doubt there is a single justice today that would believe the Dred Scott decision was either moral or constitutional. I believe that future analysts will view this Supreme Court decision in the same light. We are a constitutional republic and respect the judicial process; however, I believe that Obamacare will be reversed by the people in November who strongly disagree with the Court’s decision regarding the individual mandate.
“The Supreme Court decision does not fix Obamacare which threatens to explode our deficit, does nothing to rein in skyrocketing health care costs, and includes new job killing taxes. I remain committed to working with colleagues from both parties on common sense reforms to eliminate these disastrous effects while fixing the pre-existing condition problem, retaining coverage for post adolescent children still in school and perhaps most important, providing meaningful solution to the litigation cases excesses.”
UPDATE ADDED: John Delaney, Bartlett’s Democratic opponent: Part of the fabric of basic American rights
“I’m very pleased the Affordable Care Act was upheld. The provisions of the law will now become part of the fabric of basic American rights. It’s a good day for the Supreme Court, our government, and all Americans.”
Ron Wineholt, Maryland Chamber of Commerce: No quarrel with individual mandate, but lack of spending controls
“The Maryland Chamber didn’t have a quarrel with the individual mandate. In fact we supported state legislation for several years as part of our business agenda that would have encouraged individuals to purchase health insurance.”
“Likewise, we have supported the establishment of the state health exchange and worked with state officials on its implementation. The federal law has also had the beneficial effect of putting the brakes on new health insurance mandates at the state level by requiring states to pay for new health insurance services that they require.”
Our concerns with the federal law and state implementation have been that it appears to accelerate health care spending, rather than bending down the cost curve. The law does nothing to protect health care providers from lawsuits, which results in billions of dollars in defensive medicine. Every employer that offers health insurance will have significant costs in complying with federal and state regulations and reporting requirements. Small employers will not be enticed to offer health insurance based on the modest and complicated federal tax credit.
So while the federal healthcare law is a flawed plan, it remains the only game in town. We will be closely monitoring and participating in workgroups this summer and fall that will recommend an essential benefits package for health insurance policies and a mechanism for funding the state health exchange.