Ex-Senate leader: Health care reform law is here to stay

Repeal unlikely, Bill Frist tells Avera crowd

The health care reform law will survive even if the Supreme Court declares the individual mandate unconstitutional, former Senate Majority Leader Bill Frist said Wednesday in Sioux Falls.

"It's going to survive. It's not going to be repealed," Frist said.

Frist, a heart surgeon and Republican from Tennessee, spoke to 500 people at an Avera Health conference at the Convention Center.

Congress passed the Affordable Care Act last year with a provision requiring all citizens to buy health insurance by 2014. Several states, including South Dakota, have challenged that in court.

Frist agrees that the mandate violates the Constitution. But unlike others on both sides of the debate, he thinks parts of the law will inject enough money into health care to make the end result workable even without the mandate.

He said the law benefits from growing public support and that its long phase-in period will allow Congress, passing through several election cycles, to amend it without killing it.

"I think the individual mandate is unconstitutional. It's not the bill I would have written," Frist said. "But it's not going to fall. The law will be shaped by these elections."

Sam Wilson, associate state director for advocacy for South Dakota AARP, an agency that supports the reform act, called the individual mandate "absolutely essential" two weeks ago after an appeals court ruled against it. That ruling was one of several that probably will push the issue to the Supreme Court.

"We don't single out any part as the keystone," Wilson said Wednesday. "But it's essential if you're going to bring down the costs in the insurance market. You've got to have a way to spread the risk."

But Frist said state insurance exchanges and a mandate on businesses to provide employee health coverage will bring in substantial revenue to build on the foundation that already has 150 million Americans carrying group insurance through their employers.

A penalty of $2,000 per uninsured employee will not be adequate incentive for businesses that often spend $5,000 or more to insure workers, but a future Congress can fix that with a stiffer penalty, he said.

He called the reform law 70 percent good and 30 percent bad. He had been out of Congress for three years when the law came up for a vote last year, but he urged Republicans to support it.

Deb Fischer-Clemens, vice president of the Avera Center for Public Policy, said she is confident insurance will be competitive because of the exchanges that states, including South Dakota, are setting up. She agreed with Frist that the current system is unsustainable because of rising demands on Medicare.

"Is it the right fix? Not 100 percent. But the fix had to occur," Fischer-Clemens said.

Frist, 59, was a Republican senator from 1995 to 2007 and majority leader the last four of those years. He once was on a GOP short list of possible presidential nominees, but he said in an interview Wednesday that he is glad to be done with politics.

He spoke at the annual conference in which Avera honors health care employees from five states for initiative and quality work.

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