Even if the U.S. Supreme Court keeps the Affordable Care Act largely intact, health care will be plagued by high costs, complexity and inequities, experts told a WisPoltics.com virtual event.

The high court on Tuesday heard arguments in a Texas case that health advocates feared could lead to the end of the ACA. But a panel of health care experts said yesterday that the justices appeared to favor the continuation of the ACA.

State Deputy Insurance Commissioner Nathan Houdek said justices should consider how the ACA affects people across the country since the major elements have been “fully integrated into our health care system now” touching almost every American across the country.

The Supreme Court’s decision next year will influence how the new Congress and President-elect Joe Biden move on various health care initiatives. U.S. Senate control remains up in the air until early next year because of two Georgia run-off elections, so big moves on health care may have to yield to small efforts that can garner bipartisan support, the panel said.

“This is going to require a real modification to some of the ambitious agenda items on the health care side,” said G. William Hoagland, senior vice president at the Bipartisan Policy Center. “But that doesn’t mean things won’t happen.”

Plus, the coronavirus pandemic’s disruption of the health care system could make some changes happen sooner than expected.

Concordia University Prof. Daniel Sem, author of “Purple Solutions: A bipartisan roadmap to better healthcare in America,” said one silver lining from the pandemic is that telehealth has become more important and popular than ever. This is due to the “disruptive nature” of the pandemic and demands placed on the healthcare system.

Prof. Christine Durrance of UW-Madison’s La Follette School of Public Affairs agreed telehealth is an important innovation for health care, but she said some communities could be left out of the advancement.

“I do want to say that I think we have to be careful about the disparities that we see in health, health outcomes, health access, health quality, and the way that the COVID-19 crisis may be exacerbating those and the way that telehealth could potentially exacerbate those further,” she said.

Panelists said they saw some issues that even a divided federal government could embrace: preventing surprise medical bills, reining in prescription drug costs, extending telehealth reimbursements, expanding ways for the uninsured to get coverage and allowing for transparent markets and competition — a Trump policy.

“As long as the Biden administration doesn’t undo some of the good things that Trump had introduced … and the Republicans are willing to give him some version of universality,” Sem said.

Sem also suggested changing the way Americans use insurance would make healthcare more affordable. He said switching to a direct pay method where people pay their healthcare providers directly for regular visits, check-ups and other non-emergency needs would bring insurance premiums and deductibles down while allowing healthcare providers to focus on providing care rather than dealing with insurance companies for every patient visit.

Hoagland said adding some kind of automatic enrollment system to the act would help cover people who don’t know they’re eligible for healthcare coverage under the ACA and have bipartisan support.

While America waits for a “purple solution” for health care, panelists predict the pandemic may lead to higher costs.

“There is an expectation that at some point, the providers are going to want to recoup what they’ve lost over the last few months and that will be reflected in insurance rates going forward,” Houdek said.

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