After months of uncertainty, the Supreme Court of the United States (SCOTUS) announced its decision June 28 on the constitutionality of the Patient Protection and Affordable Care Act of 2010 (ACA). The court ruled that the key provision of the law, the individual mandate, is constitutional by a 5-4 vote. The required expansion of Medicaid coverage by states did not fare so well; that provision was struck down 7-2. We feature excerpts of reactions to the monumental ruling below.
H. Stephen Lieber, CAE, president and CEO, HIMSS
“HIMSS, like the rest of the country, is relieved that questions about the healthcare reform law have now been settled and the nation can move forward with the essential work of transforming healthcare in America. Health information technology is critical to the ongoing transformation in our nation.”
Lieber’s statement included this health IT reference: “As HIMSS has emphasized in the past, while there are many potential implications for health IT in the ACA, the Medicare and Medicaid Electronic Health Records Incentive Program was never in jeopardy regardless of the outcome of this case; that program was authorized by the HITECH Act, which was part of the American Recovery and Reinvestment Act (ARRA) of 2009, and not ACA, which was separate legislation passed in 2010.”
Karen Ignagni, president and CEO, America’s Health Insurance Plans (AHIP)
“As the reform law is implemented, health plans will continue to focus on promoting affordability and peace of mind for their beneficiaries. The law expands coverage to millions of Americans, a goal health plans have long supported, but major provisions, such as the premium tax, will have the unintended consequences of raising costs and disrupting coverage unless they are addressed.
“Health plans will continue to work with policymakers on both sides of the aisle to make coverage more affordable, give families and employers peace of mind, and promote choice and competition. Health plans also will continue to lead efforts to reform the payment and delivery system to promote prevention and wellness, help patients and physicians manage chronic disease, and reward quality care.”
Darrell G. Kirch, M.D., president and CEO, Association of American Medical Colleges (AAMC)
“With 32 million newly insured Americans entering the healthcare system, addressing the nation’s physician shortage – projected to climb to more than 90,000 by 2020 – is now more critical than ever. Medical schools have done their part, increasing enrollments during the last six years in response to these shortage projections. But the overall supply of U.S. physicians cannot expand unless Congress increases the number of federally funded residency training positions, a number that has been frozen since 1997.
“We urge Congress to move quickly to provide more federal support for additional doctor training to ensure that Americans have access to care – not just an insurance card.”
Karen A. Daley, Ph.D., MPH, RN, FAAN, president, American Nurses Association (ANA)
“Registered nurses are well positioned to lead in providing essential prevention and wellness services and care coordination for individuals and families. The law enhances opportunities for nurse practitioners and nurse midwives to provide primary care. This will increase accessibility for the growing number of people needing basic health services.”
For RNs, Daley notes, the ACA creates more opportunities to lead or participate in innovative, team-based care delivery models, such as accountable care organizations and medical homes, with incentives for nurses’ expertise in care coordination. The law also provides funding to expand nurse-managed health centers and for nursing education and workforce development.
Jeremy A. Lazarus, M.D., president, American Medical Association (AMA)
“This decision protects important improvements, such as ending coverage denials due to pre-existing conditions and lifetime caps on insurance, and allowing the 2.5 million young adults up to age 26 who gained coverage under the law to stay on their parents’ health insurance policies. The expanded healthcare coverage upheld by the Supreme Court will allow patients to see their doctors earlier rather than waiting for treatment until they are sicker and care is more expensive. The decision upholds funding for important research on the effectiveness of drugs and treatments and protects expanded coverage for prevention and wellness care, which has already benefited about 54 million Americans.
“The health reform law upheld by the Supreme Court simplifies administrative burdens, including streamlining insurance claims, so physicians and their staff can spend more time with patients and less time on paperwork. It protects those in the Medicare ‘donut hole,’ including the 5.1 million Medicare patients who saved significantly on prescription drugs in 2010 and 2011. These important changes have been made while maintaining our American system with both private and public insurers.”
Bruce Siegel, M.D., MPH, president and CEO, National Association of Public Hospitals and Health Systems (NAPH)
“The decision could allow states to opt out of the ACA’s expansion of Medicaid coverage to people below 133 percent of the federal poverty level. While the ACA provides substantial support to states to expand Medicaid, we are concerned many states will choose not to expand coverage.
“We hope states choose to do the right thing. But we cannot base federal policy on hope alone. NAPH urges Congress to avert a potentially disastrous outcome for vulnerable populations by immediately reevaluating safety-net funding in light of this decision.”
Mark Leahey, president and CEO, Medical Device Manufacturers Association (MDMA)
“If the true goal of healthcare reform is to reduce costs and to improve patient care, then Congress and the president need to repeal the device tax so America’s medical technology innovators can continue to develop cutting-edge products. Doing so will be a win-win for patients and jobs.”
