Historic Health Care Legislation

As predicted, the House of Representatives voted 245-189 to approve a bill that would repeal the Patient Protection and Affordable Health Care Act. The bill that was approved was H.R. 2, the “Repealing the Job-Killing Health Care Law Act.” All Republican members voted for repeal as well as three Democrats who voted against the health reform legislation when it originally passed the House last March. Democrats who voted for repeal were Representatives Dan Boren of Oklahoma, Mike McIntyre of North Carolina, and Mike Ross of Arkansas. Senate Majority Leader Harry Reid said that the bill would not be considered by the Democratically controlled Senate. In fact it was considered, and the repeal was defeated along party lines in a 51-47 vote. The Senate action followed a repeal in the House, which generated these headlines in the Washington Post and The New York Times respectively: “House Votes To Repeal Health-Care Law” and “House Votes for Repeal of Health Law in Symbolic Act.”

Efforts will not End With Repeal

House Republican leadership indicated that they would hold hearings in February on aspects of the health reform legislation that they believe are most objectionable. This was summed up in the Washington Post headline “Repeal Vote Won't End Health Care Debate.” Republicans have said that they support some parts of the reform legislation and Democrats have indicated that they would be willing to revise some of it, so the challenge will be whether a compromise can be reached that would pass the House and the Senate.

What Polls Show

Meanwhile polls continue to show a rather evenly divided public. A recent poll just before the House vote found that 40 percent of those surveyed favored the health reform legislation and 41 percent opposed it. “Poll: Opposition to Health Reform Eases,” Associated Press (Jan. 16, 2011). Only one in four say they wanted to repeal the law entirely. A Zogby Interactive poll found that 54 percent of those surveyed favored repeal while 43 percent did not, but 52 percent felt that the repeal vote was a “gimmick” to satisfy the bill's opponents. “Majority Wants Health Care Reform Repealed, Yet Most Say Repeal Attempt a Political Gimmick,” Zogby Interactive (Jan. 18, 2011). More than half of those surveyed (54 percent) believed that the health reform legislation would not be repealed. Another recent poll found that 55 percent of likely voters believe the health reform legislation should be repealed but only 40 percent strongly favor repeal and 30 percent strongly oppose repeal. “Most Still Favor Repeal of Health Care Law, Say It Will Increase Deficit,” Rasmussen Reports (Jan. 17, 2011).

The Courts

On the legal challenge front, six states—Iowa, Kansas, Maine, Ohio, Wisconsin, and Wyoming—joined 20 other states in their lawsuit in Florida to declare the individual mandate in the health reform law unconstitutional. Judge Roger Vinson ruled in their favor, declaring the entire law unconstitutional. The Department of Justice is likely to appeal this ruling. There are now a total of 28 states challenging the legislation in the courts. This is contrasted by an analysis signed by more than 100 constitutional law professors from across the country concluding that the individual mandate is constitutional. The American Constitution Society released a piece entitled, “Over 100 Legal Scholars Agree on Affordable Care Act's Constitutionality.” Virginia's Attorney General has asked the Supreme Court to “fast track” this case.

APsaA's Role

We are witnessing a time of change and turmoil in the delivery of and payment for health care in our country. We have a divided Congress, divided states, and in all likelihood a Supreme Court case in the near future to deliberate on these matters. What can our Association do to influence the outcome of new laws and regulations, and to protect our members and our patients? APsaA will continue to work to maintain the right to privacy which is the cornerstone of any meaningful treatment, and to be sure that our members and patients maintain the right to contract privately. Our Association will continue to take part in the Mental Health Liaison Group in Washington to monitor and influence legislation affecting our profession and our patients so that those who accept insurance will be treated fairly and without discrimination. Most importantly, we will call on you to call, write, and visit your Congressmen and other elected officials to help in this cause.