Decision a big relief for insurers [The Times Leader, Wilkes-Barre, Pa.]

June 29--While not taking sides on the Affordable Care Act itself, a high ranking official at Blue Cross of Northeastern Pennsylvania said the insurer was "relieved" the Supreme Court's ruling left the health care reform law intact rather than stripping provisions from it.

"The worst outcome," said Kim Kochler, vice president of government affairs for the Wilkes-Barre-based insurer, "would have been striking down the mandate."

That mandate, which requires most Americans to have health insurance on Jan. 1, 2014, or pay a penalty, is critically important as it will create a larger pool of payers, many of them younger and healthier, to support the cost of care for those who need it.

"That decision is important because having as many individuals as possible in the health insurance pool, especially healthy individuals, is necessary for the other market reforms included in the federal health care reform to work as intended," Kochler said.

"If you have a lot of people in the pool," said Duane Davis, the chief executive officer of The Geisinger Health Plan, "there's a better chance it will work."

Wilkes University Health Care Management Professor Justin Matus said the ruling that upheld the law in whole pleased health insurers across the nation.

"It keeps their business models viable," Matus said.

Davis said Geisinger has been implementing the law's requirements since it was passed in 2010 by including coverage for children and some adults with pre-existing conditions and allowing children up to age 26 to remain on their parents' policies.

The ruling affirms Geisinger and other health insurers have been doing the right thing, he said.

"We have long supported health reform that improves access and consumer protections, covers all Americans and includes a mandate," Davis said.

Kochler said Blue Cross also has been preparing since the law was passed in 2010 and will continue meeting the targets and deadlines. She noted that nonprofit Blue Cross, unlike many for-profit insurers, has always covered pre-existing conditions. The law, she said, brings all insurers onto "an even playing field" with the Blues.

According to the federal government, 11 percent of Pennsylvanians, 1.37 million people, are uninsured. When they need health care, the providers must absorb the cost, which in turn raises insurance rates for those who are covered.

The mandate and law as a whole aim to help curb this, Matus said.

He said that like Social Security, the system will have younger, healthier people paying into something they're not likely to use until they're older, so essentially "they're paying it forward."

"God knows at the end of their lives they'll be using more than what they're paying into it," said Matus, of Harveys Lake.

___

(c)2012 The Times Leader (Wilkes-Barre, Pa.)

Visit The Times Leader (Wilkes-Barre, Pa.) at www.timesleader.com

Distributed by MCT Information Services