Indiana scholars say the state must emerge from the surprise of the Supreme Court’s upholding of the Affordable Care Act and move quickly towards implementation of the law’s provisions.
Even before Attorney General Greg Zoeller announced he was joining a lawsuit brought by 25 other states against the legislation, state leaders had declined to begin implementing the law, in hopes the court would strike it down. Now that the law has been upheld, the state has less than two years to prepare for its full scope to kick in.
“I think what’s important for our state is that we’ve been slow to prepare for the acts kicking in—the main provisions—in 2014,” says David Orentlicher, a former Democratic state lawmaker and now the co-director of the Hall Center for Law and Health at IUPUI. “We’re going to need an exchange where people can buy health care in 2 years, and the question is will the state be able to get it up and running, or will the federal government have to come in and do it for us.”
Indiana has other connections to the ruling. Chief Justice John Roberts grew up in LaPorte County and sided with the court’s four more liberal justices in authoring Thursday’s majority opinion. And the University of Notre Dame is still fighting a portion of the law which mandates that health care providers with religious ties provide birth control.
A decision on that provision, says IU Maurer School of Law professor Dan Conkle, is still to come.
“There will be more [challenges], but I’d say we’re pretty far down the path in terms of general approval of this law in terms of the most contested provisions,” he says.
But will the law make Hoosiers healthier? IU Applied Health Sciences professor Beth Meyerson says it won’t – at least without help.
“I think what we should really focus on too is from a public health perspective, from a health of the nation perspective, is that the affordable care act will not in and of itself make a healthy nation,” Meyerson says. “But the leading causes of death in our country and illness in our country continue to be caused by this mix of social and behavioral and contextual factors that are not solved by the access to health care.”
In the wake of the decision, a number of Indiana Republican lawmakers – on both the state and local level – said they were disappointed with the ruling and how much they think it will cost the state.