What’s at stake in the health care decision

John Dimsdale Mar 26, 2012

Adriene Hill: It’s day one of Supreme Court arguments over President Barack Obama’s health care reform law. Twenty-six states are challenging the law — parts of which are already in place. We wanted to know how health care law is effecting pocketbooks today.

So we’ve got Marketplace’s John Dimsdale with us now live from Washington D.C. Good morning, John.

John Dimsdale: Good morning, Adriene.

Hill: How has healthcare spending changed since the passage of health care reform?

Dimsdale: Well, we don’t have reliable measure of costs since the law — that was 2010 when it was enacted. But we do know that the runaway medical inflation that we saw in the 1990s, and around the turn of the century, has settled down.

Health economists, like Martin Gaynor at Carnegie Mellon University, say that’s not due to the new health care law.

Martin Gaynor: Really what’s driving that slow down is not any federal policy; state, local policy.  Not the things government is or isn’t doing. It’s really just the recession overall the slowing in the economy.

And the other thing to keep in mind here is that most of the big parts of the health reform law have yet to take effect, and won’t for another year and a half — some provisions don’t even kick in until 2018. So it’s going to be a while before we have a sense of how the law affects spending.

Hill: How is cost figuring into the Supreme Court arguments?

Dimsdale: Health care’s out-of-control costs underlie the whole movement for reform. But the court’s concentrating on legal questions — for example, the legality of the individual mandate: can the government require everyone to buy insurance?

Or can the issues in the reform law be separated? Would a ruling that the insurance mandate is unconstitutional mean the rest of the law would have to be scrapped? So, these are the kinds of issues that we’re going to hear over the next three days; six hours total. And we expect a decision from the court in June.

Hill: Marketplace’s John Dimsdale, thanks.

Dimsdale: Thank you.

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