Sense of Peril for Health Law Gives Insurers Pause - “Many of us did not get the bill we wanted, but I think having to start over is worse than having to fix this.”

A very informative article in The New York Times that begins:

As the Supreme Court considers the constitutionality of the federal health care law, one option that had seemed unthinkable to its designers and supporters now seems at least possible: that the court could strike down the entire law.

Although it would be folly to predict what the court will conclude, policy experts, insurers, doctors and legislators are now seriously contemplating the repercussions of a complete change in course two years after the nation began to put the law into place.       

Their concerns were heightened after three days of court arguments in which some justices expressed skepticism about whether the full law could stand without the individual mandate requiring almost everyone to have insurance.       

“Many of us did not get the bill we wanted, but I think having to start over is worse than having to fix this,” said Robert Laszewski, a health care industry consultant and former insurance executive who opposed the bill.

Others say, however, the last two years have made it easier for Congress or the states to revisit the issue. The effort was not a waste of time, said Christine Pollack, vice president of government affairs at the Retail Industry Leaders Association, a trade group that represents large retailers and opposed the law. “There has been an important dialogue that has happened over the last three and a half years that has been a long time coming,” she said.

       

The most ambitious provisions would be nearly impossible to salvage, like the requirement that insurers offer coverage even to those with existing medical conditions and the broad expansion of the Medicaid program for the poor. Popular pieces of the legislation might survive in the market, like insuring adult children up to age 26 through their parents’ policies, along with some of the broader changes being made in the health care system in how hospitals and doctors deliver care.

Abandoning the efforts and billions of dollars invested since the law was passed in 2010 would result in turmoil for hospitals, doctors, patients and insurers.

       

Many insurers would have difficulty changing course. “The risk of repeal and starting from zero frightens them infinitely more” than having to comply with the law as written, said Michael A. Turpin, a former insurance executive who is now a senior executive at USI Insurance Services, a broker.