Good news or bad news? Court upholds health law

So. According to this statement from the Oklahoma Policy Institute, it looks as if the US Supreme Court has upheld the Affordable Care Act. I was both surprised and relieved to read this when I opened up my e-mail just now. OPI's post provides a link to the entire decision. (It's almost 200 pages long, so I'll have to read that later.)

BBC News reports that the law was upheld by a 5-4 ruling, with Chief Justice John Roberts casting the deciding vote. Justice Anthony Kennedy, sometimes described as the key swing vote on the court, wrote the dissent.

OPI welcomes this decision as a step forward in the journey to bring quality healthcare at a reasonable price to all US residents, and calls on Oklahoma lawmakers to move forward on implementing the ACA:

The Supreme Court also upheld expansion of the Medicaid program, a provision that will particularly benefit low-income uninsured Oklahomans, paid for almost entirely by the federal government.

For the 1.7 million Oklahomans who are privately insured and happy with their plan, coverage is now more secure and comprehensive. Insurers can no longer deny their claims or drop their coverage without oversight. Their insurer will now cover routine preventive care, like immunizations and cancer screenings, for no co-pay or additional out-of-pocket cost.

The health law is already working to strengthen consumer protections and ensure that Oklahomans are getting what they pay for from their insurers and providers. It’s now up to state leaders, regardless of their personal political preferences, to move forward quickly to implement the Affordable Care Act.

That's an optimistic assessment about the ACA's effects. Others have less optimistic assessments. As Physicians for a National Health Program point out:

Although the Supreme Court has upheld the Affordable Care Act (ACA), the unfortunate reality is that the law, despite its modest benefits, is not a remedy to our health care crisis: (1) it will not achieve universal coverage, as it leaves at least 26 million uninsured, (2) it will not make health care affordable to Americans with insurance, because of high co-pays and gaps in coverage that leave patients vulnerable to financial ruin in the event of serious illness, and (3) it will not control costs.

Why is this so? Because the ACA perpetuates a dominant role for the private insurance industry. Each year, that industry siphons off hundreds of billions of health care dollars for overhead, profit and the paperwork it demands from doctors and hospitals; it denies care in order to increase insurers’ bottom line; and it obstructs any serious effort to control costs.

In contrast, a single-payer, improved-Medicare-for-all system would provide truly universal, comprehensive coverage; health security for our patients and their families; and cost control. It would do so by replacing private insurers with a single, nonprofit agency like Medicare that pays all medical bills, streamlines administration, and reins in costs for medications and other supplies through its bargaining clout.

Some folks argue that the Affordable Care Act is merely the beginning of a process that will ultimately lead us to a single-payer system. Right-wing opponents of the law certainly made that case as the bill was making its way through Congress.

I would like to believe that the ACA will lead to a better system, but I'm not sure that it will. On the other hand, if the Supreme Court had struck down the law, this would have been a decisive blow against any kind of comprehensive national health insurance coverage. Thus, while I'm not particularly happy with the ACA, I am relieved that it wasn't struck down.