As the Supreme Court prepares to take on challenges to the Affordable Care Act, new data suggests that Americans remain divided on the constitutionality of the law’s requirement that all Americans purchase health insurance. Little more than half of Americans (54%) think the individual mandate should be ruled unconstitutional and that the Supreme Court will likely agree (55%), according to a recent poll by the Kaiser Family Foundation. The poll was based on telephone interviews with 1,206 adults in the United States from. Jan 12-17.
Courtesy Kaiser Family Foundation
The poll also found that more than half (59%) of Americans think the Supreme Court Justices will base their ruling on their own opinions. That sentiment is being echoed by the conservative interest group Freedom Watch, which recently filed its second petition to request Justice Elena Kagan to recuse herself. Supporters of the petition take issue with Justice Kagan’s former position as Solicitor General and close adviser to President Obama while the law was being written.
If the mandate were ruled unconstitutional, it’s not clear if the rest of the law would remain solvent. According to the poll, 55% of American thought remaining provisions of the law would survive but 30% said it would mean the end of the law entirely.
Courtesy Kaiser Family Foundation
Further, the Kaiser poll shows that Americans are split on their own opinions of the ACA. According to the poll, 44% are against the law, 37% support the law, and 19% are unsure.
However, a majority (67%) oppose the mandate because it forced American to do something they don’t want to do (30%) or because health insurance is unaffordable (25%). An additional 22% just don’t like the idea of paying a fine for not having insurance.
Those who do support the mandate (30%) said it guarantees that everyone needs health coverage (32%) and that the mandate can guarantee that (17%). Some also said the mandate could control costs (15%).
The American Medical Association’s House of Delegates meeting wrapped up on Tuesday afternoon, a day ahead of schedule. The delegates touched on a wide range of issues over the four days at the Hyatt Regency in Chicago. None was more hotly debated than whether the AMA should back the so-called individual mandate that’s a central tenet of the Affordable Care Act.
AMA delegates at work. By Alicia Ault
While much time and energy was devoted to that topic, delegates also discussed many public health, practice management and payment issues. The nation’s obesity epidemic was addressed in many resolutions. Pediatricians and medical students pushed for having the AMA take a strong stand on fast food, competitive eating, and physical education.
The annual meeting generally showcases the diversity of opinions among the nation’s physicians and among the various medical specialties that make up the House of Delegates. In the end, the policies that are adopted are supposed to reflect some kind of consensus forged out of those many voices.
But perhaps more than any year in the past, it was clear as the meeting ended that the AMA is struggling to maintain a consensus. Many state delegations complained of declining membership, which they said was directly related to dissatisfaction with how the AMA was representing them.
Take a listen to our final wrap-up podcast on the meeting proceedings.
And tell us whether you think the AMA continues to represent your voice in medicine.
Physicians at the AMA House of Delegates meeting on Sunday spent almost 3 hours debating whether the AMA should continue to support the so-called individual mandate. That mandate, which is part of the Affordable Care Act, would require Americans to purchase health insurance coverage.
Delegates in line to talk mandates. Photo by Alicia Ault
On the pro side, physicians argued that having health insurance had been shown to equate with longer and healthier lives. On the con side, many doctors said that the mandate would take away individual freedom and possibly result in the collapse of the insurance market.
Elsewhere at the meeting, physicians talked about gay marriage and civil unions, whether Medicaid should be converted to a block grant program. They also discussed a physician’s right to counsel patients about gun use.
For more, take a listen to this special edition of the Policy & Practice Podcast.
The Affordable Care Act faced its third appeals court challenge, the biggest and most important to date. This case, brought by 26 states, centers around the constitutionality of the individual mandate, as well as the massive expansion of Medicaid. The judges in the case didn’t seem persuaded to toss the law or deem its mandate unconstitutional, at least according to experts who observed the oral arguments in Atlanta. However, a final ruling is not expected for several months.
Photo courtesy of iStock
And physicans and hospitals aren’t biting when it comes to the Pioneer model for Accountable Care Organizations (ACOs). The Pioneer program, which has been offered as a sort of olive branch to health care providers unhappy with the proposed ACO rules, presents a fast track to Medicare shared savings for those who are already functioning under a coordinated care system. Medicare officials extended the deadline for applying to Pioneer by about a month — most likely prompted by the negative feedback on the ACO proposal.
As the year winds up, opponents of the Affordable Care Act are continuing to get their days in court. A week ago, a judge in Virginia ruled that the individual mandate required by health reform — that is, that everyone in America should purchase health insurance — is unconstitutional. That challenge is expected to rise to the United States Supreme Court.
Via Flickr Creative Commons user Fibonacci Blue
This week, we bring you news about a challenge brought by attorneys general in 20 states and heard in a Florida court. There, the goal is to knock off the individual mandate as well, but the opponents also say that the health reform law’s large-scale expansion of Medicaid is unconstitutional.
Meanwhile, on Capitol Hill, everyone is waiting to see which foes of health reform will be given prominent positions in the House when the new Congress returns in January. In this week’s edition, we report on some of the Republicans who have been chosen to lead the newly reconstituted House Energy and Commerce Committee.
From hearings and press conferences in Washington, D.C.
Photo of Sen. Paul Kirk courtesy of United States Senate
The Senate continues its work on health reform with a new face in the crowd: Sen. Paul Kirk (D-Mass.), who was sworn in on Friday as interim replacement for the late Sen. Ted Kennedy until a special election can be held in January. Meanwhile, the Senate Finance Committee continues to push through the 564 amendments to its health reform bill, the inter- and intra-party fights continue, and state insurance commissioners discuss their health reform goals.
It’s all in the Policy & Practice podcast. Lend us your ear and send in your thoughts.
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