June 28, 2012

SCOTUS rules on Affordable Care Act

Today, the Supreme Court of the United States issued an opinion on the constitutionality of the Patient Protection and Affordable Care Act (ACA), President Obama’s signature piece of health care reform legislation, another step on the health care reform path that began in February 2009 with President Obama saying, “So let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year,” when addressing a joint session of Congress. The court voted to uphold the law, ruling that the requirement that all individuals have health insurance (the individual mandate), the main point of debate, was within Congress’ power to impose taxes.

"The individual mandate cannot be upheld as an exercise of Congress power under the Commerce Clause. In this case however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income but choose to go without health insurance. Such legislation is within Congress' power to tax." - Chief Justice John Roberts, in the majority opinion

The lawyers at SCOTUSblog summarized the ruling this way:

The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.

According to HIMSS, health IT-related provisions set forth in the ACA include quality reporting, quality measure development, health IT interoperability standards and protocols, availability of Medicare data for performance measurement, and administrative simplification. ACA health IT-related provisions provide a foundation for Accountable Care Organizations (ACOs), health information exchanges (HIEs), and patient education established and promoted by ACA.

Here’s a look at additional coverage of the decision from media across the country:

Josh Levs with CNN writes about lesser known ways the ACA will impact Americans, including more breastfeeding rooms and requiring chain restaurants to list calories under every menu.

Ana Wilde Mathews with the Wall Street Journal writes, “Though the coming election and expected budget negotiations could throw off more changes, the Supreme Court's decision to effectively uphold most of the law removes a big question mark and will add momentum to shifts that were already in progress.”

Ana’s colleagues, Christopher Weaver and Louise Radnofsky, write about how the decision affects hospitals, medical device makers and employers, respectively.

John Cushman with The New York Times writes that, “The case is seen as the most significant before the court since Bush v. Gore ruling, which decided the 2000 presidential election. In addition to its political reverberations, the decision allows sweeping policy changes affecting one of the largest and fastest-growing sectors of the economy, touching nearly everyone from the cradle to the grave.”