By Johnny Kampis | Missouri Watchdog
In a shock to many health-care experts and politicians in Missouri, the Supreme Court on Thursday upheld all parts of the Patient Protection and Affordable Care Act.

Supporters of President Obama’s health care law gather Thursday outside the U.S. Supreme Court building in Washington, D.C. (Photo by Carten Cordell)
Most expected the Supreme Court to at least overturn the mandate requiring individuals to buy health insurance – a provision that even had the state’s Democratic governor, Jay Nixon, breaking ranks. He told reporters earlier this week that “having the government order you to buy something like that is not something that in the past I’ve supported.”
Now lawmakers and health-care providers will scramble to both implement the law and fund its provisions.
Jon Dolan, executive director of the Missouri Health Care Association, told Missouri Watchdog that the $40 billion reduction in Medicare provider payments will hurt the nursing home industry, which his organization represents.
“Supposedly we’re supposed to find this money and provide the care,” said Dolan, a former Missouri legislator.
Lt. Gov. Peter Kinder, who filed his own lawsuit against the health care act after Missouri declined to join 26 others who challenged the mandate, said Thursday that President Obama and Congress had “imposed the largest tax increase on the American people in our history.”
“Today’s decision underscores the dire importance of pending lawsuits such as my own, the November election and the need for the full repeal of this monstrous tax on Americans,” he said.
Missouri residents will cast a largely symbolic vote related to the health-care act this November when they decide whether the governor and Legislature should be allowed to establish an online marketplace where patients can shop for insurance policies.
It’s symbolic because the state would be unlikely to meet a Nov. 16 deadline to submit an insurance exchange plan to the U.S. Department of Health and Human Services, after the Nov. 6 general election.
Nixon’s administration halted efforts to create the exchange earlier this year. The Missouri General Assembly doesn’t meet again until January.
About 16 percent of the Missouri population was uninsured in 2010, according to the U.S. Census Bureau.
Missouri voters snubbed their nose at the act in August 2010, when 71 percent cast ballots in favor of a proposition that barred the government from requiring people to buy health insurance. This vote was also symbolic, since federal laws trump state statutes.
Now that the health-care act is upheld, Rep. Chris Moldendorp, R-Raymore, said if Missouri voters pass the November proposition he would sponsor a bill in January to persuade Washington to accept a state-based plan after the application deadline.
“I’m sure Health and Human Services would grant us an extension of 90 or 120 days,” he told Watchdog. “Because of today’s ruling Missouri is not the only state in this boat.”
Molendorp expressed surprise that Chief Justice John Roberts “came together with the liberals” of the court.
“This is one of those seminal moments in American history,” he said. “I’m glad I was around to see it.”
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