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Providers, Payers Largely Favor PPACA Decision

Cheryl Clark, for HealthLeaders Media, June 29, 2012

• 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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1 comments on "Providers, Payers Largely Favor PPACA Decision"


R Daniel King (6/29/2012 at 4:33 PM)
First, how does an inefficient, quality challenged government agency provide the leadership in designing a path to an efficient, quality-driven health care delivery system? ObamaCare is a coffin not vehicle to the Golden Age of Medicine and it appears some are blinded by the idea that there will be more patients paying $7 for a service costing $100. What the Supremes have upheld is the right for government to limit freedoms, limit profits and dictate what medical services will be given for free. Today it is only health insurers, tomorrow everything else. Once government claims everyone has "government" insurance and cost shifting is something in the past, nothing stops CMS from limiting hospital CEO salaries based on a factor times the average nurses salary because "it's fair" and all his hospital patients now pay. How about creating profit ceilings to" make it fair" by controlling the profit range between specialist and primary care physicians? Or say that a hospital that exceeds a 5% profit threshold has to give the excess to a competing hospital that is not close to the threshold to "make it fair." We are knee deep in an entitlement culture that wants governmen to "make it fair." Which is exactly what health care leadership is presently doing, waiting for government. Remember, four Supremes found the WHOLE law unconstitutional. Roberts had to import a reference to taxes which is unprecedented. Now, there is nothing stopping government from adding the "tax" to FICA for subsidizing the uninsured poor so all your patients can pay. Remember, Democrats stated during the ObamaCare debate, "it would be so much easier if we could just tax like we do Medicare." Robert's has granted their wish. With profit controls and mandated free services on private insurers, how many do you think will be left in five years? What will be left will be "Medicare" for everyone with universal price controls, hundreds of oversight agencies and hundreds of thousands of regulations, all freedom killers, quality killers and inflation builders. The Democrats are presently on a full court press to attach anyone who makes reference to "the tax" and mandate in the same sentence, because they do not want the voters to connect the dots before November. I do not feel the tingle up my leg that the individuals in this article are feeling.