Health-care prognosis: cloudy

By Jack Torry

The Columbus Dispatch Sunday June 10, 2012 10:56 AM

The U.S. Supreme Court is on the verge of ruling on the new health-care law, a decision that could throw health care into temporary chaos as providers and patients scramble to adjust to a wave of uncertainty in the system.

The justices, who might issue their decision as early as this week, could deliver a staggering political blow to President Barack Obama by striking down the 2010 law, the signature achievement of the presidents first term, designed to extend health care to millions of Americans without insurance.

The court also could stun conservative Republicans by giving their seal of approval to the law. Republicans in Congress joined by GOP state attorneys general objected that it unconstitutionally forced individuals to buy health insurance.

A growing number of analysts, however, suggest that five of the justices will cobble together a fractured series of opinions that could leave parts of the law intact while striking down other sections. Such a ruling could create confusion for hospitals, physicians and patients.

I think hospitals want clear direction either way, not just in the Supreme Court decision, but in all areas of public policy, said Jonathan Archey, a lobbyist for the Ohio Hospital Association. Whatever the Supreme Court does, were still going to have the issues that the (law) was designed to deal with.

The courts key votes belong to Justice Anthony Kennedy and, to a lesser extent, Chief Justice John Roberts. With the courts four liberal justices likely to uphold the law and conservative justices Antonin Scalia, Samuel Alito and Clarence Thomas seemingly hostile to it, Kennedy may emerge as he usually does the pivotal vote.

Hes always subject to the next mornings barometer readings, said Thomas Miller, a resident fellow and health analyst at the Washington-based American Enterprise Institute. But based on the way oral arguments unfolded, the best reading is that hes a vote against the individual mandate, but not a vote against striking down the entire structure.

Its hard it to get five votes to throw everything out the door because of (the courts) nervousness about being something that sweeping, Miller continued.

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Health-care prognosis: cloudy

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