Local doctor reacts to Supreme Court health care decision - KWWL - Eastern Iowa Breaking News, Weather, Closings

Local doctor reacts to Supreme Court health care decision

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WATERLOO (KWWL) -

The High Court has declared at least part of the controversial "Patient Protection and Affordable Health Care Act" constitutional. The Supreme Court of the United States ruled Thursday that Congress can require everyone in the country to either have health insurance or pay a penalty tax.

That portion of the opinion is getting the bulk of the attention from pundits and politicians, but it is only one part of the 193 page ruling.

Another big part of decision deals with Medicaid -- specifically, whether Congress can require states to cover all individuals whose income is below 133 percent of the poverty line. The Supreme Court ruled "no", it can't, and as a local doctor explained, that might be the Achilles heel in the implementation of the Affordable Health Care Act.

Waterloo Doctor Paul Franke left his regular practice as an internist seven years ago to work as the Vice President of Medical Affairs for Covenant Medical Center. But his drive to care for the health of others is still strong -- which is why, a few times a month, he volunteers at IHOPE -- a local free clinic.

"People at the clinic are stripped down to the essential human nature. Which is somebody who is sick, somebody who has a need, and from a values perspective, I feel it's important, personally and professionally, that we help that person," he said.

Franke believes strongly that every American should have the right to basic health care, which is why he's followed the Affordable Care Act closely. While some are applauding the High Court's upholding of the so-called "health insurance mandate", Franke is concerned about their decision on another aspect of the law.

"For a certain segment of the population, we may not see that much expansion -- particularly for people of a much lower income," he explained.

The Court struck down a requirement for states to expand their Medicaid coverage to include anyone living below 133 percent of the poverty line, or lose their federal Medicaid funding. Under the Affordable Health Care Act, the federal government will cover the expense for the first three years, gradually decreasing after that to 90 percent match. In the Supreme Court opinion, the Chief Justice said this is "much more than relatively mild encouragement -- it is a gun to the head."

It's not clear at this point which states will still take part or which will opt out -- potentially leaving many of their low-income residents without any insurance.

"Now that they don't have to participate, even a ten percent cost to the state in an expansionary mode, is not going to be attractive. States are trying to cut. So I have a feeling that free clinics, clinics like the IHope Clinic, will have plenty of business," said Franke.

It's not exactly the kind of job security Franke is looking for, but he's glad he, and other volunteers, are able and willing to help.

Franke believes, even with the Affordable Health Care Act in place, the real problems in the health care industry have yet to be addressed. Those problems include profiteering at the expense of the health of Americans, the cost of education for doctors and nurses, and the lack of quality health services in various regions of the country -- especially in rural communities and inner-cities.

Click here to read the SCOTUS decision.

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