CHARLESTON, W.Va. -- While the Affordable Care Act will cost $1 trillion over a decade, the sweeping health-care legislation will reduce national debt over the long term, according to a local physician and state senator."I think it's going to improve the cost and quality of health care in the country over time," said state Sen. Dan Foster, D-Kanawha.Foster said recent reports indicate the health-care reform act will reduce the national debt by about $210 billion over 10 years.Without reform, there will be no rapid movement toward delivery and payment reform, both of which are necessary measures, Foster said."We're paid for the frequency of our care and the intensity of our care, not how well people do," Foster said of physicians. "We're very good at taking people who are very sick and getting them well. We don't do a good job at keeping them from getting sick because it doesn't pay well."Foster said health-care costs need to be addressed, even if the ACA or parts of it are struck down. Those costs will be more readily addressed if the law stands, he said.The U.S. Supreme Court recently heard arguments over the constitutionality of the legislation. A decision is expected in June.Foster's comments came following a panel discussion about the health-care reform act Monday at a meeting of the Rotary Club of Charleston. The discussion, "The Affordable Healthcare Act: Obama Care or Obama Cares?" brought together three different perspectives on health-care reform: consumer, provider and taxpayer.Along with Foster, the other panelists were Ted Cheatham, director of the West Virginia Public Employees Insurance Agency, and Chris Colenda, chancellor for health sciences at West Virginia University.Cheatham argued that the health-care reform act would cost taxpayers money in insurance premiums and taxes."Any time, as a general rule, that you mandate anything, it's going to cost money," he said. "That doesn't mean it's not a good thing, it just means it's going to cost money."Cheatham said insurance providers have two pages of new preventative health services that they are required to pay for under the ACA. Insurance companies also must cover young adults up to age 26. For PEIA, that means about 4,000 more young adults would be covered, he said.Another requirement is that insurance companies offer patients a booklet about their benefits. That will cost taxpayers $58 million, Cheatham said.Colenda said that the reform act could impact the WVU hospital system's unpaid charity care.Last year, WVU Healthcare paid $100 million in unpaid charity care, he said."If reform reduces the number of uninsured, this cost may drop," Colenda said. But the hospital could become "vulnerable" if the rate of insurance coverage drops faster than the number of people getting coverage, he said.WVU, like other teaching schools, is vulnerable under the health-care reform act, he said."Even though we are big and we are vulnerable, most health science centers will change their delivery of health-care services and, by default, the [way we teach] the next generation of health-care professionals."Reach Lori Kersey at firstname.lastname@example.org or 304-348-1240.