Rice University health care experts available to comment on Supreme Court’s impending Affordable Care Act ruling

David Ruth

Jeff Falk

Rice University health care experts available to comment on Supreme Court’s impending Affordable Care Act ruling
Ho and Marks: Stakes are high for all Americans  

HOUSTON – (June 19, 2012) – As the U.S. Supreme Court prepares to rule on the constitutionality of the Affordable Care Act (ACA) this month, the stakes are high for all Americans. What the nine justices decide, and exactly how they craft their lengthy opinion, has been the topic of much speculation.

Two health care experts at Rice University’s Baker Institute for Public Policy can speak about the potential ruling’s local and national implications and why Texas is an example of what the nation will look like without ACA:

  • Vivian Ho, the James A. Baker III Institute Chair in Health Economics.
  • Elena Marks, the Baker Institute Scholar in Health Policy.

Ho’s key points:

  • “Some of the nation’s most highly regarded economists with years of experience in health economics promoted the inclusion of the individual mandate in the ACA. The mandate is a vital partner to the ACA’s requirement that insurers accept all customers in 2014 regardless of pre-existing conditions. Without the mandate, people could forgo the purchase of health insurance while they are healthy, then buy insurance if they fall seriously ill and require significant medical care. Their costs would drive up costs for insurers, who would then have to pass these expenses on in terms of higher health insurance premiums to all of their customers. Thus, the mandate prevents free riders from taking advantage of honest customers as well as taxpayers, who foot the bill for many of the uninsured through local public hospitals and clinics. That said, the overwhelming majority of the ACA can still stand without the mandate.”
  • “If the entire ACA is struck down by the Supreme Court, health care costs will continue to consume a larger portion of our nation’s economy and a larger share of workers’ paychecks for the foreseeable future. The legislation is a dramatic attempt to solve a dramatic problem facing our economy and the well-being of our citizens. There are no easy to solutions to the problem. The ACA was written with the advice of some of the best health economists in the country, based on years of research and the best data available.”

Marks’ key points:

  • “Texas is an example of what the rest of the US will begin to look like without ACA: The goals of the ACA were to increase access to care and rein in costs that routinely outpaced all other indices. The primary mechanism for increasing access was to increase insurance coverage — for poor people through a Medicaid expansion, and for others through changes in the health insurance industry. The insurance industry changes would be effected through the combination of the mandates (there are large employer mandates as well) and new industry regulations including guaranteed issue, community-rated pricing, medical loss ratio requirements and premium setting rules. These reforms would have benefited Texas more than any other state –because we have the largest percentage of uninsured. Texas is a poor state — with 25 percent of the population living in poverty, compared to 16 percent nationwide. Thus, Medicaid expansion would have benefited Texas more than most states. Of the 6 million uninsured Texans, 2.6 million would be covered under expanded Medicaid.” 
  • “An additional 2.8 million Texans living just above the poverty line would qualify for subsidies with which to purchase private insurance in a market subject to consumer-protective regulations. Currently, health plans in Texas are not required to spend any particular amount of premium dollars on medical care, and they are not even required to report to their customers how they spend premium dollars. They are also allowed to raise their premiums as much as they want without regulatory approval. Because of the ACA, in 2012, 92 percent of the Texans who purchased plans in the individual market will receive rebates of approximately $127 million from insurance companies that did not meet the ACA’s medical loss ratio requirements. This is more than any other state; the next highest was Florida at $29 million.” 

The Baker Institute has a radio and television studio available for media who want to schedule an interview with Ho or Marks. For more information, contact David Ruth at david@rice.edu or 713-348-6327.


Related materials: 

Ho biography: http://bakerinstitute.org/personnel/fellows-scholars/vho

Marks biography: http://bakerinstitute.org/personnel/fellows-scholars/emarks

Founded in 1993, the James A. Baker III Institute for Public Policy at Rice University in Houston ranks among the top 20 university-affiliated think tanks globally and top 30 think tanks in the United States. As a premier nonpartisan think tank, the institute sponsors more than 20 programs that conduct research on domestic and foreign policy issues with the goal of bridging the gap between the theory and practice of public policy. The institute’s strong track record of achievement reflects the work of its endowed fellows and Rice University scholars. Learn more about the institute at www.bakerinstitute.org or on the institute’s blog, http://blogs.chron.com/bakerblog.

About Jeff Falk

Jeff Falk is associate director of national media relations in Rice University's Office of Public Affairs.