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Practical Effect of Supreme Court’s Decision Upholding the Affordable Care Act

by Edward J. Kroger, MD, JD on June 28th, 2012

As we predicted, the Affordable Care Act has now withstood Constitutional challenges.

We also predicted substantial legislative gridlock in federal legislation, Medicare benefits would not be curtailed, that the chance of tort reform was modest at best, and that health care costs would increase – all which has occurred since the 2010 elections.

Today’s decision by the U.S. Supreme Court is consistent with our predictions. It will also affect healthcare providers in a number of different ways.  Rather than focus on the technical aspects of the decision, following are our observations regarding how different views of the decision will potentially impact health care.

A careful student of the political, economic and social realities of the United States in 2012 cannot help but appreciate the following:

  • There is no societal or political will to reduce medical services.
  • The amount of health care being delivered will increase due to technology and demographics.

Based on those principles, today’s ruling could be interpreted in at least two ways. Those who favor the decision will cite the increased access to health care as a victory, pointing to the following:

  • Those who make too much to qualify for Medicaid and too little to afford insurance will have coverage.
  • Potentially, Emergency Departments will be used less as a primary care center for those without health insurance, shortening the wait time for true emergencies.
  • Those with pre-existing conditions will be able to obtain coverage.
  • The “doughnut hole” in prescription drug coverage for seniors will be eliminated by 2020.

Those who disagree with the decision will maintain that the ACA will create more problems than it solves, such as the following:

  • Legislators on the state and federal level will respond by passing increasingly complex legislation in the unrealistic hope that costs can be controlled without any reduction in services.
  • The increased demand for medical services coupled with the shrinking numbers of physicians (due to stricter CMS payment guidelines) could functionally restrict access to care, as the wait times for appointments will likely become longer.
  • Health care costs will continue to increase as they become increasingly unaffordable by individuals and businesses and swamp the federal budget.
  • For the foreseeable future, health care services and costs in the United States will continue to expand in an increasingly complex regulatory environment.

 It is expected that the Republican-led House will attempt to repeal the ACA.  In addition, the ACA will be used by both parties’ candidates in the November presidential election.  In short, the debate regarding how to improve health care will continue.

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From → Health Law