Obamacare Stands, Now Focus Shifts to Costs

Christopher Cheney, July 1, 2015

The Patient Protection and Affordable Care Act appears firmly in place as long as President Obama remains in office. But affordability remains the Achilles heel of the healthcare reform law, observers say.

Certainty is one of the most solid and sought after building blocks for any market.

Last week's Supreme Court decision upholding subsidies for health plans purchased on federally operated insurance exchanges provides a measure of certainty to the health insurance market. For the foreseeable future, the highest court in the land has signaled emphatically that it will not overturn the Patient Protection and Affordable Care Act. And for the next two years, President Obama is certain to protect and build out the PPACA, his signature domestic policy.

Jim Nathan

Theda Skocpol

After last week's ruling, Theda Skocpol, a professor of government and sociology at Harvard University in Cambridge, MA, co-authored a New York Times opinion piece that cast the King v. Burwell decision as a PPACA turning point.

"The new framework being put in place by the Affordable Care Act is taking hold—this thing moved rapidly," Skocpol told me this week. "The court ruling makes it impossible to undo it."

The president has gained an edge in PPACA politics, she says. "There's going to be a lot of chest thumping from Republicans. House Republicans are going to hold more hearings. Barack Obama is not signing off on any of that."

SCOTUS Upholds Obamacare, Leaders React

For the second time since passage of the PPACA in 2010, Chief Justice John Roberts wrote the majority opinion in a case that could have disrupted or derailed the healthcare reform law. For the second time, the Supreme Court upheld a key element of the PPACA, and further existential challenges to the healthcare reform law in the highest court in the land appear unlikely.

Roberts, who is widely viewed as a conservative on the court and who wrote the minority opinion in last week's landmark decision legalizing gay marriage, has sent a pro-PPACA signal to the Republican Party, Skocpol says.

Christopher Cheney

Christopher Cheney is the senior finance editor at HealthLeaders Media.

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