Providers, Payers Largely Favor PPACA Decision
• Bruce Siegel, MD, of the National Association of Public Hospitals and Health Systems, said in a statement that he's "concerned by (the decision's) potential to limit Medicaid expansion, which could strand millions of our most disadvantaged people without access to basic health care coverage" by allowing states to opt out of Medicaid coverage for those below 133% of the federal poverty level.
"We are concerned many states will choose not to expand coverage. Indeed, in the 26 states that participated in the federal lawsuit, more than 27 million people have no insurance and many who would have been eligible for Medicaid in 2014 might no longer have that option," he said.
"Safety net hospitals and health systems lead innovation in quality of care and access, and do so with limited resources. We must support safety net patients and the hospitals and health systems that serve them with a stronger funding commitment."
• Moody's investor service issued a statement advising that the impact of the decision will be neutral to slightly positive economically for the industry because expansion of insurance coverage "will lessen hospital operators’ exposure to bad debts, which in turn will improve margins and cash flow at for-profit hospitals.
"However, we expect that the growth rate of Medicare reimbursement will also slow down, offsetting the benefit of lower bad-debt expense. Provisions in the healthcare law call for reductions to annual updates and for lower disproportionate share payments, which are government payments designed to help compensate hospitals for treating uninsured and indigent patients."
• Premier Healthcare Alliance's President and CEO Susan DeVore issued a statement saying that the ACA's quality requirements, such as hospital value-based purchasing (VBP) rules, creation of Medicare-based accountable care organizations and national pilots to test bundled payments "are important policy levers that are moving healthcare forward, and each of these enhancements has strong public and bipartisan support," as is the Center for Medicare and Medicaid Intervention, to increase transparency, reduce variation and avoid unnecessary costs.
• The Association of American Medical Colleges said it, too, is pleased with the decision. But President and CEO Darrell G. Kirch, MD, said in a statement that the law may be insufficient unless Congress increases the number of federally funded residency training positions to meet the demand of larger numbers of insured, "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."
• The Pharmaceutical Research and Manufacturers of America (PhRMA) said it respects the court's decision and will work with the administration and Congress on refinements. But it also wants to change the law, specifically strive "to repeal the Independent Payment Advisory Board."
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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