The Supreme Court ruling Thursday upholding the Affordable Care Act drew kudos and disappointment locally, as people digested the impact of the decision.
Erin Tacke, a Dyer woman who traveled to India this year for spine surgery, supported it.
"Obviously, the health care system needs to be reformed," she said. "I like the idea of putting it as a tax so those who really don't want to get insurance, then it will be 1 percent of their income."
Tacke flew to India because her insurance company would not cover necessary back surgery. She had a previous condition and agreed to the company's terms because she needed insurance.
"I didn't ask for cancer, I didn't ask for a bad back," she said. "I shouldn't be punished or singled out because I've had (those conditions)."
The Affordable Health Care Act will help people in similar situations.
"It would've changed everything," she said.
Namely, the surgery would have been sooner, and perhaps she would not have the degree of nerve damage she experiences.
"I may never recover from the nerve damage," Tacke said. "I don't think it's right, all because the insurance companies not wanting to put me on."
Hobart resident Toni Puentes Modglin posted on The Times Facebook page in support of the ruling.
"As the parent of a child with special needs, parts of this bill are a lifesaver for my son, especially considering the changes Indiana is considering for the Medicaid waiver program," she wrote. "It makes me sleep better at night knowing he will be able to stay on my health insurance until he is 26 and that there will not be a lifetime cap on his benefits. I don't agree with everything in the bill, but for my family, the positives far out weigh the negatives."
Dr. Alexander Stemer, president and CEO of Medical Specialists Inc., said his greatest concern is the ruling's blow to the Medicaid program.
"The single most important part of that act was the expansion of Medicaid," he said.
Raising the ceiling would allow more families into the program. Stemer said that plan would have been more palatable to Americans than the Affordable Care Act.
"Had this administration simply said there's 13 million Americans too poor to afford health insurance, expand Medicaid ... it would not have divided the country," he said.
Stemer said he predicted to his board Monday that the act would be upheld.
"Clearly, (Supreme Court Chief Justice John) Roberts bought the, 'It's a tax' rather than 'It's a penalty' argument," Stemer said.
A number of questions remain regarding implementation and impact. Stemer said he suspects low-cost insurance for people will mean higher deductibles.
In a statement, Samuel Flint, associate director of Indiana University Northwest's School of Public and Environmental Affairs, wrote that the Affordable Care Act, while less than perfect, will dramatically improve the country by opening the health care system's door to 32 million uninsured citizens, the majority of whom are employed.
"It will subsidize small-business health insurance costs, improve Medicare by expanding its benefits, and adding a decade to the solvency of its Trust Fund, and it won’t add a nickel to the national debt,” he said. “Those who profit from the inefficient, unfair status quo generate myths about death panels and out-of-control spending to confuse the public. However, objective observers need only to look at the positive results in the state of Massachusetts to gauge the progress that this plan has made there and multiply that by 50 to project the level of progress that will be made under the ACA once it is implemented nationwide.”
Diocese of Gary Bishop Dale Melczek issued a statement saying he could not comment yet because he needed more time to familiarize himself with the ruling and its implications.
"As you know, the SCOTUS decision on the Affordable Care Act was lengthy and obviously will have many implications going forward," according to the statement.
A full overturn of the Affordable Care Act would have put an end to the Health and Human Services mandate that some religious institutions have opposed, saying it violates their religious freedom.
The HHS has mandated that employer health plans should cover preventive medicine, including contraceptives and sterilization, which go against the tenets of some religions.
Federal lawsuits have been filed in opposition to the mandate.
Franciscan Alliance CEO Gene Diamond said the ruling said nothing about the contraception mandate, nor did it address the question of abortion funding.
Franciscan Alliance had opted into the litigation to support the effort of the United States Conference of Catholic Bishops.
Diamond said he was surprised by the Supreme Court's decision.
"It's a fairly complex decision," he said. "It's going to take some time to understand exactly what the court said and what it means, but it's clear the law is constitutional."