UPDATED: Supreme Court Obamacare Vote Could Hurt Local Health Care Providers

Thursday’s , better known as “Obamacare” or “the ACA,” is leaving Southwest Minneapolis’ healthcare providers unsure about the future.

"On one hand, I'm a very socially liberal person. Affordable health care is a great goal," Dr. Moe Smith of Moe Bodyworks told Patch. "But as a business owner I know that under the Affordable Care Act the ones who stand to be screwed the most are my kind of small clinic."

Southwest Minneapolis is dotted with small chiropractic clinics and dentists’ offices.

"If all my cash-paying (uninsured) patients end up having government-funded health insurance, that's the lowest rate of reimbursement of all the major plans," she explained. "If that happens as a result of this, I stand to make a lot less per patient, and I can only work so many hours in a day"

Around half of those who will gain access to insurance through the Affordable Care Act will do so through the expansion of state-level Medicaid programs. As NPR reported Wednesday:

The law would expand Medicaid coverage to everyone with incomes under 133 percent of the federal poverty level. In 2012, that's $14,856. In practice, the expansion will mostly cover adults without children or disabilities, since low-income children, parents and those with disabilities are mostly already eligible.

However, Dr. Jonathan Olson of said he was waiting to see how insurance companies react to provisions in the ACA that push for more preventative care—those same, formerly cash-paying, newly-insured patients might not get coverage for the services he and Smith provide.

“Overall, we know lifestyle management and wellness care makes sense, and insurance companies have been moving in that direction,” he said.

The cost should theoretically be lower because people will have fewer surgeries, he said, but insurance companies haven’t done enough research to see if that theory holds up in real life. In addition, he said, many chiropractors cost much less than a traditional emergency room visit, meaning more people are able to afford the care out-of-pocket. 

Insurers: Full Steam Ahead

While small providers may be worried for the future, Minnesota's health insurance providers are gung-ho for Thursday's vote, which lets them charge ahead on plans they've been making since the Affordable Care Act was passed two years ago.

"Blue Cross and Blue Shield of Minnesota will continue the work we began more than two years ago of implementing the law in a manner that strives to serve the best interests of our members and all Minnesotans," said a Blue Cross spokesperson in an email to Patch.

Other insurers were similarly pleased.

"Overall, we are pleased that the Supreme Court has released their decision because now we know the context in which we move forward," a Fairview spokesperson said in a statement emailed to Patch. "Fairview remains committed to transforming care and payment systems to improve care, improve patient experience and reduce the total cost of care. For us, it is all about creating greater value for those we serve."

Check back regularly as we update this article with reactions from other local residents, businesses, and health care providers!