US Supreme Court Upholds ACA

As widely reported yesterday and summarized this morning by the American Health Care Association (AHCA), the U.S. Supreme Court ruled that the Affordable Care Act's (ACA) individual health insurance mandate does not violate the Constitution because it may be viewed as a permissible tax on individuals who do not obtain health insurance.  The only provision of the law that the Court invalidated is a Medicaid provision that threatened states with the loss of all existing Medicaid funding if they decline to comply with the ACA's Medicaid coverage extension.  By preserving the vast majority of the landmark health reform law, the Court avoided the policy chaos that would have resulted from striking down the ACA in its entirety.  There is now legal certainty for state and federal governments, health care providers and suppliers, drug and device manufacturers, employers and individuals.  Although the legal battle is over, the political battle will continue.  A copy of the US Supreme Court opinion can be found here.  A copy of AHCA/NCAL’s General Counsel, Reed Smith, analysis of the US Supreme Court litigation can be read on the Health Industry Washington Watch website.  Additionally, AHCA/NCAL's Labor Counsel, Jackson Lewis, has also provided its analysis of yesterday's decision.

The focus will now return to continuing implementation of the law.  The Centers for Medicare & Medicaid Services and other agencies are under pressure to comply with deadlines to get proposed and final rules released.  States also must increase activities to get Health Exchanges up and running by the 2014 deadline.  Currently, fewer than half of the States have authorized legislation to establish an Exchange; but many more States have taken the Department of Health & Human Services grant funding and are issuing requests for proposals for the necessary information technology work necessary to set up Health Exchanges.   Virginia has not passed legislation necessary to establish a state-run insurance exchange.  States have until November 16th of this year to declare whether they will create their own exchanges along with a plan for governing them. If they do not, the federal government has indicated that it will establish and operate the exchanges in those states.

Providers too must continue in their efforts to comply with the ACA and be prepared to comply with requirements that take effect as early as 2012-13.  Especially troubling for skilled nursing facilities are the Medicare payment reductions incorporated in the ACA.  Impact estimates prepared by AHCA show that Virginia facilities will incur Medicare cuts totaling $367 million between FY 2012 and FY 2019.  To obtain a copy of the cumulative ACA requirements and timelines important for providers go to AHCA/NCAL’s website.