WHEELING - The health care industry now wants to know who pays the cost of health care reform, says Ronald Violi, CEO of Wheeling Hospital.
"It's a nightmare," he said. "Nobody can figure it out. ... We're more confused today than we were yesterday. The decision waited so long for has come down as no decision. No one knows how to deal with it."
Officials at Ohio Valley Medical Center did not immediately respond to requests for comment.
In its ruling Thursday, the court affirmed most of President Barack Obama's health care reform law, including the mandate that individuals must have health care coverage. But it also rejected a provision of the law that places the financial burden of expanding Medicaid on the states.
Chief Justice John Roberts joined liberal Justices Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor in the 5-4 decision. Dissenting justices were Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas.
Under a plan to pay for health care reform, the amount of federal dollars a state receives to pay for Medicaid coverage would be reduced if the state wasn't willing to extend coverage as is required under law, said U.S. Sen. Rob Portman, R-Ohio.
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CANDIDATES SOUND OFF ON COURT'S RULING
- Bill Maloney, Republican for West Virginia governor: "I am disappointed by the decision of the Supreme Court today because I know that ObamaCare is bad for West Virginia and for the country. It costs too much, taxes too much, expands government too much, kills jobs and puts the federal government between you and your doctor."
- John Raese, Republican for U.S. Senate in West Virginia: "After today's Supreme Court decision, the stakes for November's election could not be any higher. Whoever West Virginians elect to the United States Senate will hold the fate of our nation in their hands. With the High Court's decision today, a Congressional repeal is the only way we will fulfill the will of the people and overturn Obamacare."
- Josh Mandel, Republican for U.S. Senate in Ohio: "Today's Supreme Court decision sets the stage for the November election. Now, the only way the American people can stop the federal government's takeover of health care is to change the people we send to Washington."
- Charlie Wilson, Democrat for U.S. House, Ohio's 6th District: "Here's the good news for the people of Eastern Ohio - the doughnut hole is closed, the cost of prescription drugs are lower and families can keep children on their parents' plan until the age of 26 - yet this law is not perfect. I look forward to working with members of both parties to improve the law by giving states more flexibility to innovate, to hold down costs and to help small businesses spend less on health care and more on creating jobs."
- Sue Thorn, Democrat for U.S. House, West Virginia's 1st District: "I am heartened to learn that critical elements of the deficit-reducing Affordable Care Act have been upheld by the Supreme Court. People with pre-existing conditions shouldn't be denied coverage, and people who get sick shouldn't be dropped from their insurance policies. I'm happy that the Medicare 'doughnut hole' will continue to close, so our seniors won't be left without life-saving prescription drugs."
"It's like giving the states a waiver on the new Medicaid provisions," Portman said. "States will now have more flexibility and choice. ... You want states to be able to cover the Medicaid-eligible population in ways that are innovative and creative and increase wellness and prevention ... and to keep costs down and cover more people. That's very difficult to do the way the law is written."
He added if Republican Mitt Romney is elected president in November, it is likely Romney will seek to give waivers to all 50 states pertaining to increasing health care offerings.
"This will put pressure on Congress to come up with an alternative" method of paying for health care, Portman added.
Sen. Jay Rockefeller, D-W.Va. said he is concerned about the impact the Supreme Court's ruling could have on Medicaid expansion.
"When we wrote the law, we worked very hard to make sure that low-income Americans who aren't currently eligible for Medicaid, but still can't afford to pay for health insurance, are given an affordable option through the expansion of Medicaid," Rockefeller said. "It appears the ruling could have seriously undermined their health care options.
"The decision still leaves in place an enormous financial incentive for states to do the right thing and expand coverage to this group. I hope every state will do that because these are good people who effectively have no other realistic option for affordable health care."
West Virginia Gov. Earl Ray Tomblin said state officials are continuing to examine the ruling.
"We know what the law is but as I've said before, I will continue to do what is best for West Virginia," he said. "We all know health care costs continue to rise and our health care system must be more efficient. We're going to review the Supreme Court's ruling and work with our federal delegation on how we move forward."
The Supreme Court justices, appointed by presidents of both parties over the years, "made an independent legal judgment to uphold the health law," noted Sen. Sherrod Brown, D-Ohio.
"I hope today's ruling will put an end to the partisan bickering so that we can continue our focus on jobs and improving the economy," he said.
Rep. David McKinley, R-W.Va., called health care reform "just bad policy."
"We will continue our fight to fully repeal Obamacare," he said. "All Americans should have the right to make their own health care choices. Restricting choice and punishing individuals and employers is the wrong way to reform health care, whether the court agrees or not.
"Once Obamacare is fully repealed, we will not rush into the same mistakes made by President Obama and the Democrats," he continued. "We need to listen to the American people to get health care reform right, and we should take the time to do so."
The Supreme Court's decision to leave President Obama's takeover of health care intact "is deeply disappointing," added Rep. Bill Johnson, R-Ohio.
"This disastrous law is full of broken promises covered in empty political rhetoric that continue to make our economy worse," he said. "Over 40 percent of small businesses are saying that this law is keeping them from hiring and expanding. The cost of this law has surged to almost $2 trillion, and doctors are already limiting the number of patients they are seeing."
Rep. Shelley Moore Capito, R-W.Va., said she has overwhelmingly heard from West Virginians they believe the president's health care law is the wrong direction for America.
"While I respect the Supreme Court's decision, I continue to believe that this law is bad for West Virginia families and the American economy," she said. "I have voted to repeal, dismantle and defund this law multiple times, and I will once again cast my vote for repeal in July."
Rep. Bob Gibbs, R-Ohio, added he also was disappointed by the Supreme Court's ruling.
"But the fact that this law was ruled partially constitutional does not mean it is good for the American people," he said. "Our job creators have been hampered by Obamacare's endless regulations and taxes, making it expensive and harder to hire new employees. Since being elected to Congress I have been focused on trying to create an environment to encourage job creators to expand and invest.
Sen. Joe Manchin, D-W.Va., noted the health care challenges that many West Virginians and Americans face won't go to away unless Congress takes additional action to repair health care reform law.
"Now that the court has ruled, we can move forward with fixing what is wrong with this bill and saving what is right," he said. "I have always been determined to reduce the burden on states from the Medicaid expansion, and this ruling affirms my position - and makes clear that states must have the flexibility to live within their means by determining Medicaid eligibility as each state sees fit. I have always said one size doesn't fit all.
"In addition, I believe there are several parts of this bill that are good for West Virginians - especially ending discrimination against people with pre-existing conditions, improving access to preventive care and eliminating the prescription drug doughnut hole for seniors," Manchin continued.


