Hospital executives have their fingers crossed that the Supreme Court will uphold the Affordable Care Act, because so many of their patients lack insurance.
If it is struck down, they said at a health summit in Fort Lauderdale today, hospitals will be in a real bind. They'll still be required to take all comers, insured or not, while staggered by budget cuts.
The Florida Legislature has cut Medicaid pay to hospitals each of the last two sessions. Their Medicare pay will take a hit if Congress doesn't act to forestall automatic cuts at the end of the year.
"We're in for a roller-coaster ride," said University of Miami President Donna Shalala, keynote speaker for the summit, sponsored by the South Florida Hospital and Healthcare Association.
Shalala, who served as health secretary in the Clinton Administration, said she thinks the law will be upheld when the court issues its ruling later this month.
"Most people think the worst that can happen is the mandate will be thrown out," she said, referring to the requirement that all Americans buy health insurance.
Odds are against the mandate, said a legal expert who attended the Supreme Court arguments in March on behalf of the American Hospital Association.
Dominic Perella of Hogan and Lovells, the firm that wrote the AHA amicus brief supporting the law, told the summit audience he thinks it's about 60 percent likely that the court will strike the mandate.
It's less likely that the whole law will go away, he said: "The Supreme Court has never struck down a law this big and sprawling."
The insurance industry is worried that the mandate will go but leave the rest of the law, which requires insurers to accept all applicants. Without the mandate, insurers worry that only the sick will apply.
But Shalala said the law's subsidies for insurance policies should bring in enough healthy people to balance it out.
Florida is the lead plaintiff in a multistate lawsuit against the Patient Protection and Affordable Care Act, arguing that both the mandate and the law's expansion of Medicaid are unconstitutional.
--Health News Florida is an independent online publication dedicated to journalism in the public interest. Contact Editor Carol Gentry at 727-410-3266 or by e-mail at Carol.Gentry@HealthNewsFlorida.org.
