- GW Home
- About GW
- University Life
- News & Events
- Faculty And Staff
SPHHS Hosts Symposium on the Future of Health Care Reform
July 13, 2012
HHS Secretary Kathleen Sebelius and former Sen. Tom Daschle were among the many health policy experts that discussed the implications of the recent Supreme Court decision on the Affordable Care Act during a policy forum at GW.
July 13, 2012
By Jennifer Eder
Less than two weeks after the Supreme Court upheld the majority of the Affordable Care Act (ACA), the George Washington School of Public Health and Health Services held a symposium on the implications for health care and public health following the court’s historic decision.
In a 5-4 decision, the court found the minimum coverage requirement – known as the individual mandate – to be constitutional. The Medicaid expansion, which expands Medicaid coverage to all Americans younger than 65 who earn under 133 percent of the federal poverty level, was also found to be constitutional. If states, however, choose not to extend eligibility, the federal government cannot restrict the federal dollars the state already receives for its Medicaid program.
“This is a transformational moment equal if not exceeding in history anything our country has experienced in 200 years,” said former Sen. Tom Daschle, D-S.D. “So you’re witnessing history in its rawest and most unpredictable form.”
While some governors have indicated they will not expand Medicaid in their states, both Sen. Daschle and U.S. Health and Human Services Secretary Kathleen Sebelius said they believe all states will eventually make the expansion, taking the generous federal match rate.
“This has unprecedented federal support, access to affordable coverage for low-income residents and steep reductions in costs for the state, citizens and health care providers,” said Ms. Sebelius. “We think at the end of the day this is a deal states won’t want to turn down.”
Under the health care reform law, the federal government will fund 100 percent of the costs of expanding Medicaid for the first three years, gradually decreasing to 90 percent by 2020 and thereafter.
Ms. Sebelius pointed to the creation of the Children’s Health Insurance Program – a joint state- and federal-funded program that provides health insurance to low-income children who do not qualify for Medicaid – as an example of how states have at first been reluctant to expand voluntary programs but eventually decide the benefits outweigh the costs. Initially in 1997 only eight states began covering eligible children, but within three years all states implemented the program.
“Now that the Supreme Court has issued their decision, I’m hopeful we can stop refighting the old political battles and trying to take away benefits that millions of Americans are already enjoying,” said Ms. Sebelius. “And to instead move forward in implementing and improving the law to provide more security to Americans who have insurance, more choices for those who don’t and lower costs for everyone.”
More than 250 people attended the policy forum in the Jack Morton Auditorium while hundreds more from around the country watched via webcam. The symposium, which was sponsored by the Kovler Foundation and GW trustee and SPHHS Dean’s Council member Peter Kovler and his wife Judy Kovler, was held on the same day the U.S. House of Representatives voted for the 33rd time to repeal the ACA.
While the repeal is not expected to pass the Democratic-controlled U.S. Senate, the symbolic impact of the House’s vote speaks to the ideological differences surrounding the appropriate role of government in health, said Sen. Daschle, who now serves as a senior policy adviser in the government affairs practice at the law firm DLA Piper. And while the Supreme Court ruled on the constitutionality of the individual mandate and the Medicaid expansion, the legal issues and policy debates surrounding the ACA are not fully resolved, he said.
Challenges will persist around budget battles over funding certain ACA provisions, and health care is promising to be front and center throughout the election this fall as presidential Republican nominee Mitt Romney has promised to repeal and replace the ACA if elected, said Sen. Daschle.
“Who ultimately gets elected as president in November is going to have a whole lot to say about health care not just for the next four years but the next 40,” he said.
A third keynote speaker at the symposium, Sheila Burke, a faculty member at the John F. Kennedy School of Government at Harvard University and former chief of staff to former Sen. Bob Dole, R-Kan., said nothing is straightforward about the ACA’s future.
“The hurdles ahead are both political and practical and really reflect the deep divisions within the country about fundamental issues,” said Ms. Burke.
In addition to whether states will expand Medicaid, Ms. Burke said questions remain around whether states will create health insurance exchanges –marketplaces for individuals and small businesses to buy coverage – or leave it to the federal government to implement, and whether funding will exist to provide low-income Americans with subsidies to purchase insurance.
“Health reform hardly stopped when we passed the Affordable Care Act,” said Sara Rosenbaum, the Harold and Jane Hirsh Professor of Health Law and Policy, who holds appointments in SPHHS, GW’s Law School and the School of Medicine and Health Serivces.
During the symposium Ms. Rosenbaum led a panel discussion amongst leading health policy experts, including Melinda Hatton, general counsel to the American Hospital Association; Karen Ignagni, president of America’s Health Insurance Plans; Ron Pollack, executive director for Families USA, the national organization for health care consumers; and Sonya Schwartz, program director at the National Academy for State Health Policy.
“How well the ACA is implemented will in the end determine the ultimate success or failure in recognizing universal coverage,” said SPHHS Dean Lynn Goldman. “So even though this is a turning point to be celebrated, there is much more to do.”
To watch a video of the symposium, click here.