On Thursday, California Health and Human Services Agency Secretary Diana Dooley said that California will continue implementing elements of the federal health reform law, even if the Supreme Court rules that the law is unconstitutional, the Sacramento Bee reports.
Her remarks came the day after the high court finished hearing oral arguments about the Affordable Care Act.
The Supreme Court case centers on whether the federal government can require residents to purchase insurance and whether federal lawmakers have the power to pressure states to expand insurance coverage through Medicaid.
The court is expected to make a decision by the end of June (Siders, Sacramento Bee, 3/30).
The Kaiser Family Foundation has estimated that California could receive an additional $45 billion to $55 billion in federal funds between 2014 and 2019 if the health reform law is upheld (California Healthline, 3/29).
In an interview with Capital Public Radio's "KXJZ News," Dooley said, "I believe that the law will be upheld. But I'm also working very hard to assure that we have as much benefit for California as possible, even if we don't have the full promise of the Act."
She said that without financial support from the federal government, "it will be very hard for us to move forward to expand health coverage." She said the state would have to balance its budget "and get California on a strong footing to do any of this work."
As called for under the health reform law, California is using federal funding to build a health insurance exchange.
Dooley said, "My agenda is to use as much of that [funding] as possible, as quickly as possible, to be sure California has a marketplace even if we don't have the full promise of the ACA" (Bartolone, "KXJZ News," Capital Public Radio, 3/28).
Dooley said that if the Supreme Court rules against the federal health reform law, California should consider implementing its own universal health care legislation that requires all state residents to buy insurance.
She said, "I think that we should be committed to making this system more rational than it is today, and improving the health of the people of California," adding, "If we ask the insurance plans to take everybody and insure everybody with no screens for pre-existing conditions, then we have to have everybody buying some level of health insurance to meet their responsibility to the system" (Sacramento Bee, 3/30).
Dooley said, "The Supreme Court will define how California will move forward and how quickly California will move forward" with health reform. She added, "[I]f we have to do it without our federal partners, we will find a way to do it. But it will be a much better transition to better health if we can do it with the benefits of the Affordable Care Act" ("KXJZ News," Capital Public Radio, 3/28).