The likelihood of a repeal of federal health care reforms was discussed Saturday as Rep. Jo Ann Emerson spoke to health care professionals during a women's health symposium in Cape Girardeau.

The event, hosted by the Cape Girardeau County Area Medical Society, drew about 20 doctors, nurses and other health care providers to the Plaza Conference Center.

Dr. Ramiro Icaza asked Emerson if there is a chance to repeal the Patient Protection and Affordable Care Act if President Barack Obama is not re-elected. Emerson said the only scenario in which that could happen is if the Republican Party wins a majority in the U.S. Senate and Republican Mitt Romney is elected president.

Because the U.S. Supreme Court's ruling on the legislation declared the fines individuals would be required to pay for not purchasing insurance coverage are really a tax, it would take 51 votes in the Senate to repeal the tax, Emerson said.

She said there are 21 new taxes included in the health care reform legislation.

"You can't just say 'I repeal this' and do an executive order. It's far too complicated. That sounds like a great sound bite, but the law doesn't allow that," she said. "You repeal those 21 taxes and then you start taking apart the law piece by piece."

The Affordable Care Act is expected to cost between $1.74 trillion and $1.9 trillion to implement, Emerson said. It also includes a $716 billion Medicare cut made up of decreases in reimbursements for home health, hospice, Medicare Advantage and nursing homes.

In Missouri, health care reform is expected to cost the state $335 million between 2014 and 2020, she said. Missouri is also one of 34 states that will lose child-only insurance policies, which are not allowed under the Affordable Care Act.

There are, however, some elements of the legislation that have broad support from both sides of the aisle, including requiring insurance companies to cover people with pre-existing conditions, allowing parents to keep their children on their health insurance plans until age 26 and preventive screenings provided at no cost to the insured.

Emerson estimates that doctors' incomes will decrease as much as 15 to 20 percent, depending on their specialty.

Dr. John Moll said a lot of private practitioners will no longer see their private practice as viable and will end up working for hospitals.

"One thing that concerns me is the right to practice according to what they believe and their own moral principles," Moll said.

Emerson said the House has passed legislation to ensure that all providers can "follow their consciences" but that it doesn't go far enough.

"When it comes to the Affordable Care Act, we've got some grave concerns," she said.

While many are talking about repealing or chipping away at health care reform, Dr. Don Centro of Sikeston, Mo., asked if anyone has come up with an alternative plan.

"There is doubt among a lot of my colleagues that the whole system is broken," Emerson said. "We know health care costs are rising far too high far too fast and that health care is taking over the discretionary budget we have far too quickly and that something has to be done."

The lack of competition in the marketplace is problematic, she said.

mmiller@semissourian.com

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