Bay Area elected officials responded enthusiastically to Thursday's historic Supreme Court ruling upholding most of the federal Affordable Care Act.
Members of the Santa Clara County Board of Supervisors expressed relief and delight about the decision.
“This is a great and historic day and we are thrilled with the Supreme Court decision,” said Supervisor Liz Kniss, chairwoman of the County Santa Clara Board of Supervisors’ Health and Hospital Committee. “This means provisions in the legislation such as coverage for pre-existing conditions, elimination of arbitrary benefit caps, and inclusion of standard prevention appointments with your doctor will be covered. Thousands of uninsured county residents will now have access to affordable coverage.”
There are about 220,000 people in Santa Clara County who are uninsured, and about 138,000 will be covered under the Affordable Care Act. Sixty-five percent (90,000) are likely to benefit from the California Health Benefit Exchange. The remaining 48,000 individuals likely will be eligible under the expansion of Medicaid Coverage, county officials said in a press release.
“The County of Santa Clara has always supported expanding coverage to the uninsured and we’ve done well in covering more people through our Low Income Health Program, which is called Valley Care,” said Board of Supervisors' President George Shirakawa. “It’s the right thing to do.”
All hospitals are required by law to provide health care to uninsured residents during emergencies, according to county officials.
During fiscal year 2012, the county spent $95 million to provide health care to the uninsured residents. Now, many people let disease and illness progress to the point that they need expensive emergency room care. In 2014, when the Affordable Care Act goes into full effect, the amount will significantly decrease. There will be more incentive for preventive health measures, the said.
“We already have about 10,400 people signed up, but with estimates that there are another 48,000 folks in our county who are uninsured and will be eligible for Medi-Cal under the Medicaid Coverage Expansion,” said René Santiago, deputy county executive for the Health and Hospital System. “Because of our foresight, especially by the Board of Supervisors, the investments needed to successfully serve this increase in insured clients, have been and are being made.”
House Minority Leader Nancy Pelosi said that the decision is a victory for the American people. "With this ruling, Americans will benefit from critical patient protections, lower costs for the middle class, more coverage for families, and greater accountability for the insurance industry," Pelosi said.
Congressman John Garamendi, D-Fairfield, a former state insurance commissioner, said, "The Supreme Court sided with our authority to improve health care for all Americans."
Sen. Barbara Boxer called the ruling "great news for the millions of Californians who have already seen the benefits of this law."
But California Republican Party Chair Tom Del Beccaro said, "Today, our American system of government changed dramatically if not irrevocably. Congress can now tax citizens into doing what it wants," Del Beccaro said.
Santa Clara University constitutional law professor Margaret Russell agreed that the decision is historic but at the same time called it "narrow and careful."
"It will be part of the legacy for which the Roberts court is known," Russell said.
Chief Justice John Roberts, together with four liberal members of the court, formed the 5-4 majority upholding the law's centerpiece, a mandate requiring that most Americans buy health insurance or to pay a penalty.
Roberts wrote that the penalty "may reasonably be characterized as a tax" and is therefore within Congress' constitutional taxing power.
The chief justice wrote, "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness."
Roberts and four conservative justices rejected another argument in which the Obama administration claimed that the law was a valid exercise of Congress' power to regulate interstate commerce. But because a majority upheld the 2010 measure on the taxation ground, it remains in effect.
Russell said that while Roberts' vote to uphold the law may have seemed surprising at first glance, his reasoning in accordance with strong existing case law affirming Congress' taxation power.
She said she considers the ruling historically significant because of its impact on both the expansion of health care coverage and the public perception of the court's role.
She said Roberts' vote is consistent with his statement during Senate confirmation hearings in 2005 that judges "are like umpires" who apply rules but don't make them. Roberts was nominated by President George W. Bush.
—Bay City News Service and Patch Staff