Friday June 29, 2012

Thrill, shock, ire -- and indifference.

In the only state where the individual health care mandate is already law, the U.S. Supreme Court’s decision to uphold Obamacare was equal parts titillating and shrug-inducing. But while many of the provisions of the law are already a reality in Mass achusetts, local health care advocates said that the court’s ruling on Thursday will help to further lower the state’s number of uninsured and assist the commonwealth in stemming its medical costs.

"I’m absolutely thrilled that the law passed," said Chip Joffe-Halpern, executive di rector of Ecu-Health Care in North Adams. "It will actually mean a lot for Massachusetts."

Following its passage of health care reform in 2006, Massachusetts has notched the lowest portion of uninsured residents of the 50 states, with estimates between 2 and 5 percent in 2010 -- or between 120,000 and 370,000 people. Nonetheless, the federal law’s implementation through 2014 could help close the gap for another 75,000 in the commonwealth, Joffe-Halpern said: The provision that currently offers subsidized care to residents up to 300 percent above the poverty level will widen to include those up to 400 percent above.

"Even though we have the fewest number of uninsured in the country, there are still folks who are above the income guidelines for the subsidized plans and are not eligible for employer-sponsored coverage," Joffe-Halpern said.

Thursday’s decision also dissipates the cloud of uncertainty regarding the Af fordable Care Act. Mass achusetts and other states can now move forward with health care reforms knowing that the federal government is on the same page, officials said.

Bryan Ayars, CEO of Great Barrington-based Community Health Programs (CHP), noted that with the federal government’s support, Massachusetts will be better situated to improve primary care and lower overall health care costs.

"I think where we will see progress is the state’s willingness to move forward on some of the initiatives that will improve particularly primary care both in access and quality measures," Ayars said. "While the state made the first step of improving access, they’re now in the second phase trying to regulate cost, and having the federal government in step with the state is going to make that much easier."

As these changes roll out, some said, the effect on most residents and businesses in the commonwealth will likely be far less earth-shaking than on those in the other 49 states.

Michael Supranowicz, president and CEO of the Berk shire Chamber of Commerce, noted that the decision today was for Massachusetts businesses only a "small hiccup." Since the passage of state health care reform six years ago, he said, business owners have learned how to deal with the new rules -- and in many cases found them beneficial.

"Most of the business community that had to put these things into effect found it’s a good way to keep employees," Supranowicz said.

What remains to be seen, Supranowicz said, is how differences in the state and federal laws would be reconciled -- Massachusetts’ surcharge to certain businesses that don’t offer health care, compared to Obama’s tax break for small businesses that do, for instance.

On Thursday, some locals said they thought of Obama care as an over-reaching of the federal government’s powers. At a farmers market outside of Community Health Programs, several local growers expressed disappointment with the Supreme Court’s ruling.

"I’m amazed, shocked. I’m not happy with it," said Judy Deming, 71, of High Country Farm in Tolland. "We have our own personal insurance. It’s none of his business. The president should take care of the president’s business, and not dictate to the poor how we run our lives."