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Healthcare Overhaul: Pros and Cons for Texas


The Supreme Court will rule this month on the federal health care law – as early as this week. BJ Austin talked with health care policy expert Anne Dunkelberg and Texas Attorney General Greg Abbott.

Texas is among two dozen states suing to stop the Affordable Care Act. During the coming weeks, KERA will look at how that law would affect Texans.

First, BJ Austin talked with Dunkelberg, Associate Director for the Center for Public Policy Priorities, and Abbott about the law – and the individual mandate requiring most uninsured to buy health coverage or pay a penalty.

Austin: Why is the Affordable Care Act, the 2010 healthcare bill, bad for Texas, bad enough to take all the way to the Supreme Court?

Abbott: Well it is bad for Texas, for Texans – their pocketbooks.  In this case, Congress had no authority to impose the individual mandate. For the first time in American history, it forces Americans to go out and purchase a product whether they want to or not.

Austin:  Forty-nine of 50 states require auto liability insurance?

Abbott:  Auto insurance is different than the United States government compelling you to purchase health insurance. States don’t require everyone to purchase auto insurance.  There are millions of people who live in Manhattan who will never drive a car. Those people aren’t required to purchase auto insurance.  With regard to health care, even people who choose not to go to a hospital, not to go to a doctor, they are nevertheless required to purchase healthcare insurance whether they want to or not. What this lawsuit is really all about is trying to ensure we protect the Constitution from it being trampled by the United States Congress by passing a law that it doesn’t have the power to pass.

Austin:  Okay, the Supreme Court rules shortly. And having been actually in the courtroom for most of the arguments, what’s your prediction?

Abbott:  It sure seems like they are going to agree with Texas that the law should be struck down as unconstitutional.  However, you cannot always take to the bank comments made from the bench during oral arguments.  If you measure what happened in the courtroom, Texas clearly won the day. And we just hope the justices agree to vote the way they spoke in the courtroom.

Austin:  On the other side of the fence is Anne Dunkelberg, health policy expert and Associate Director of the Center for Public Policy Priorities.  Why is the Affordable Care Act, the 2010 health care bill, good for Texas?

Dunkleberg: Texas has the highest percentage of uninsured residents in the entire country and also the highest percentage of uninsured kids. We also have the unpleasant distinction of being the place where healthcare premiums are growing at the fastest rate in the country.

The health reform law, imperfect as it is, offers the first major step forward to making affordable, good healthcare coverage available to every us citizen regardless of your their income level.

Austin: The constitutionality of the individual mandate – you’re a healthcare policy expert, but maybe put on a legal hat?

Dunkleberg: The individual mandate was not an end. It was not a goal of health reform, it was something that was put in there really at the request of the health insurance industry because if they’re going to operate in a new world where they can no longer turn anybody down because of their health history and preexisting conditions, and where they can’t charge people more because they’re sick, they want to make sure all the healthy people are in the pool too, not just the sick people. And again, you have to remember we’re not talking about people who already have insurance. We’re talking about the percentage of Americans and Texans who aren’t covered today.

Austin: Looking at the Supreme Court case, what is your prediction? What do you think they’ll do?

Dunkleberg: I’m inclined to think that plucking out the individual mandate might be the most likely outcome, but I would not claim any expertise to justify that.

Center for Public Policy Priorities

Former KERA reporter BJ Austin spent more than 25 years in broadcast journalism, anchoring and reporting in Atlanta, New York, New Orleans and Dallas. Along the way, she covered Atlanta City Hall, the Georgia Legislature and the corruption trials of Louisiana Gov. Edwin Edwards.