PORTLAND, Maine — Most people agree that the national health reform law passed in 2010 ushers in a new era in American health care.
That’s about where the consensus on the law ends, if a public forum held Wednesday night in Portland is any indication. Hosted by the progressive advocacy group Consumers for Affordable Health Care, the forum at the University of Southern Maine’s Muskie School of Public Service dug into the law’s constitutionality and policy implications, featuring experts arguing both for and against the landmark legislation.
John McDonough, a Harvard public health professor, said the Patient Protection and Affordable Care Act marks the best chance in this lifetime to get America’s health care system right.
“This moment of innovation is just so important to capture and move and take advantage of to try to create a system that better meets the needs and desires and values of the American people,” said McDonough, who was recruited in 2008 as part of the late Sen. Ted Kennedy’s push for national health care reform.
President Barack Obama’s health care overhaul aims to expand health coverage to 35 million more people by 2014. It sets up state health insurance exchanges where consumers and businesses can shop for plans and emphasizes preventive care, among many other initiatives.
McDonough highlighted a provision that rewards hospitals financially for reducing unnecessary re-admissions and medical errors.
On the other side of the debate was Amy Lischko, a Tufts University School of Medicine professor who objects to the law’s “one-size-fits all” approach.
Lischko formerly headed up health finance and policy in Massachusetts under then-Gov. Mitt Romney, where she crossed paths with McDonough, a key advocate of the commonwealth’s 2006 health reforms.
Lischko summed up what she liked about the 2,000-page law — it doesn’t set up a government-run health insurance system, for one — in roughly 20 seconds.
She spent more time disputing an often-cited report by the nonpartisan Congressional Budget Office, which found the ACA would cut the deficit by $210 billion over 10 years.
“I’ll eat my shoe if it reduces the deficit, fully implemented,” she said.
Lischko also detailed many states’ objection to footing the bill to expand Medicaid coverage, as required by the law, and shouldering the burden of implementing complex legislation they oppose.
Twenty six states, including Maine, are challenging as unconstitutional the ACA’s requirement, known as the “individual mandate,” that nearly all Americans purchase health insurance by 2014 or pay a penalty.
The U.S. Supreme Court will hear oral arguments in the case at the end of March, with a decision expected by June.
Colby College law professor Joseph Reisert argued that the mandate goes beyond the limited powers afforded to the federal government under the Constitution.
“If the government can do this, why can’t it make you buy, I don’t know, a car, or maybe make you eat broccoli?” he said.
Cabanne Howard, a former law professor at USM, countered that the mandate falls within Congress’ power to regulate the economy. Since everyone else pays when an uninsured person needs health care, he said, the choice not to buy coverage is an economic decision, he said.
“If the court does not intervene and strike this [legal challenge] down, it’ll just be a naked political act,” Howard said.
The event was co-sponsored by the Muskie School of Public Service and the University of Maine School of Law.