Political battle over US health care continues

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It was not the end of the story when the Affordable Care Act was passed in 2010. Its implementation is being fought every inch of the way; the Republican Party is split even though voter polls say 70% would scrap the whole Act or at least its central plank.

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FDA bill revised to cut deficit
29 May 2012 - House Republicans have changed their FDA bill enough to get a positive score from the Congressional Budget Office (CBO). A new CBO analysis says the amended bill will reduce the deficit by US$370 million over the next decade. The version that passed the Energy and Commerce Committee earlier this month would have added nearly US$250 million to the deficit, according to CBO.

The main purpose of the FDA bill is to reauthorise user fees the agency collects from drug and medical device companies. It also creates a new fee for the companies that make generic drugs, and makes several changes to FDA’s regulatory policies. As the revised bill enjoys wide support, it should be signed into law by President Obama by 4 July 2012.

Tension ahead of high court decision
The President’s Affordable Care Act was argued before the Supreme Court over three days in March 2012 [1]. Twenty-six States, individuals, the National Federation of Independent Business and others challenged the government on the law’s constitutionality. The court will rule in June 2012.

Republicans say they will work to repeal the rest of the law if only the mandate is struck down. But they went quiet when asked whether Republicans would take immediate action to help people who might lose their health coverage because of the Supreme Court ruling. If the court does rule against the legitimacy of the Act, President Obama has expressed concerns that he might have to revisit health care in a second term.

The issues
Several issues are at stake in this case. The one receiving the most attention is the individual mandate, which says most individuals must purchase health insurance. Opponents say the government is overreaching by mandating people purchase a product from a private company.

The other question, which is receiving less attention, is the law’s expansion of Medicaid. States say it places an undue burden on them to pay for the expansion of the healthcare programme for the poor. The federal government says this is another expansion of Medicaid, which has happened several times before, and the rules are the same: participate with the federal funds allocated or opt out of the entire programme.

Finally, if the individual mandate or the Medicaid provision is struck down, the Court will decide if the entire healthcare law stands or if the provisions can be severed from the law. The Court could strike down just the individual mandate, the Medicaid expansion or the entire law. The justices could also determine the entire law constitutional.

The court has upheld the legality of Congress’ legislation since the New Deal*.

*The New Deal was a comprehensive series of social and economic programmes enacted during the Great Depression by the Franklin D Roosevelt Administration that have become part of our everyday lives today.


1.  GaBI Online - Generics and Biosimilars Initiative. US Supreme court looks set to challenge Affordable Care Act [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2012 Jun 18]. Available from: www.gabionline.net/Biosimilars/General/US-Supreme-Court-looks-set-to-challenge-Affordable-Care-Act

Source: CBS News, The Hill, US Supreme Court

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