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Healthcare Stakeholders React to SCOTUS Upholding ACA for Third Time

Analysis  |  By Melanie Blackman  
   June 17, 2021

America's Essential Hospitals called the ruling in California v. Texas a "decisive victory for patients [and] hospitals."

Healthcare stakeholders and leaders reacted to the U.S. Supreme Court's decision to uphold the Affordable Care Act (ACA) in California v. Texas Thursday morning.

In a 7-2 ruling, the Court ruled that the plaintiffs do not have standing to sue over the landmark healthcare law's individual mandate.

Healthcare organization leaders, industry observers, and members of the U.S. government have released the following statements in reaction to today's ruling.

Department of Health and Human Services (HHS) Secretary Xavier Becerra issued a statement calling the ruling a "victory for all Americans" while adding that healthcare is "a right."

In his previous role as California Attorney General, Becerra led a coalition of nearly 20 states in defense of the law and filed a petition of certiorari with the Supreme Court to hear the case on an expedited basis.

"Today’s decision means that all Americans continue to have a right to access affordable care, free of discrimination," Becerra said. "More than 133 million people with pre-existing conditions, like cancer, asthma or diabetes, can have peace of mind knowing that the health protections they rely on are safe. Women who need access to birth control, life-saving maternity care and preventive care can rest easy, knowing that their care is protected and covered. Seniors and people with disabilities can breathe easy knowing their health protections will continue. Individuals who have faced discrimination can continue accessing care without fear. And people relying on Medicaid and Medicare should know these programs are stronger than ever."

The Centers for Medicare & Medicaid Administrator, Chiquita Brooks-LaSure, who has worked to implement the ACA, calls the ruling a "victory."

"From my early career on the House Ways and Means Committee, I worked on this life-saving law. And later in a leadership post at CMS, I worked to implement the ACA – and the results are clear. Tens of millions of Americans can no longer be discriminated against due to pre-existing conditions like cancer, asthma, or diabetes," Brooks-LaSure said. "[But] our work is far from finished. CMS is focused on building on the successes of ACA to further expand access to health coverage. Thanks to the ACA and President Biden's American Rescue Plan, coverage on is more affordable than ever before."

America's Essential Hospitals issued a statement celebrating the ruling, calling it a "decisive victory for patients, hospitals, and all who believe no one, especially people of limited financial means, should go without access to affordable healthcare."

"Through the ACA, our nation took a historic step toward realizing a world without barriers to a need as fundamental to living as shelter, food, and education. This ruling preserves important progress in our work to make that vision a reality," Bruce Siegel, MD, MPH, CEO of AEH said in a statement. "With this decision, we urge Congress and the administration to act to close gaps in coverage, promote health equity, and invest in hospitals that care for people who face social and financial hardships. We must put underrepresented populations and underserved communities highest on the list of priorities for next steps in the journey to equitable and accessible care for all."

Similarly, the Federation of American Hospitals (FAH) stated that the millions of Americans receiving coverage under the ACA can "breathe a sigh of relief" after the Court's decision Thursday.

"We applaud the Supreme Court for overwhelmingly upholding the ACA and hope that this latest challenge to the law will be the last," Chip Kahn, CEO of FAH, said in a statement.

The American Medical Association (AMA) was pleased with the ruling, referring to the decision as a "victory for patients and for the gains in healthcare coverage" achieved through ACA.

"With yet another court decision upholding the ACA now behind us, we remain committed to strengthening the current law and look forward to policymakers advancing solutions to improve the ACA," American Medical Association President, Gerald E. Harmon, MD, said in a statement. "The AMA will continue working to expand access to health care and ensure that all Americans have meaningful, comprehensive, and affordable health coverage to improve the health of the nation."

America's Health Insurance Plans (AHIP) applauded the decision, adding that "it is clear" that efforts should be made to build on the ACA.

"We believe the Supreme Court rightly concluded this case does not belong in court, as the challengers have not suffered any injury," Matt Eyles, CEO of AHIP, said in a statement. "The ACA remains the law of the land and a foundational component of health care and coverage for more than 300 million Americans. After a year filled with unprecedented loss when reliable comprehensive health coverage has never been more important, this decision protects the stability of health coverage for people with pre-existing conditions, hardworking families, seniors, and other Americans who need it most."

Blue Cross Blue Shield Association (BCBSA) also celebrated the news.

"We are pleased with today’s decision dismissing the challenge to the Affordable Care Act. The ACA has made health care more accessible by providing 31 million people health care coverage. Right now, 90% of Americans have health coverage through their jobs, the individual market, Medicare and Medicaid," Kim Keck, CEO of BCBSA, said in a statement. "Today’s decision now gives the nation an opportunity to meaningfully tackle the underlying cost of health care – one of the most critical challenges in the health care system."

CareFirst is "pleased that the key provisions of the ACA remain in effect."

"[CareFirst] will continue to promote access to affordable health insurance for the individuals we serve and all Americans," President and CEO of CareFirst BlueCross BlueShield, Brian D. Pieninck, said in a statement. "CareFirst looks forward to continuing our work with Federal and state policymakers to maintain and improve access to healthcare throughout our region."

The Association for Community Affiliated Plans (ACAP) called the ruling a "victory for all Americans."

“In ten years, the ACA has been subjected to constant threats. Consumers have too long paid the price for the uncertainty these attacks bring about," ACAP CEO, Margaret A. Murray said in a statement. “Enough is enough. It’s time to stop attacking our health care system and time instead to repair, reform, and reinforce it so every American has access to quality, affordable, comprehensive coverage.”

The American Hospital Association (AHA) said that while "more than 30 million Americans who secured health insurance under the ACA can again breathe a sigh of relief ... our work is far from over."

"We need to redouble our efforts to close coverage gaps and make care affordable and accessible for everyone, all while continuing to fight COVID-19 and encouraging more Americans to get vaccinated," AHA CEO, Rick Pollack said. "The AHA is eager to partner with Congress and the Biden administration to make sure all Americans can achieve their highest potential for health."

The American College of Physicians (ACP) stated that was "glad" to see the ACA remain in place.

"Eliminating the coverage, benefits and protections provided by this law would have thrown our health care system into chaos, and placed health care for millions of Americans in jeopardy," George M. Abraham, MD, MPH, FACP, FIDSA, president of ACP, said in a statement. "We are glad that the justices saw the need for the law to remain in place."

The Association of American Medical Colleges (AAMC) was encouraged by the ruling and urged the Biden administration to increase the accessibility of coverage options for Americans.

"The AAMC applauds the Supreme Court’s decision today to uphold the Affordable Care Act (ACA), which will help safeguard access to high-quality and affordable health care for millions across the country," David J. Skorton, MD, CEO of AAMC, said in a statement. "This decision is instrumental in ensuring that all people can access care and more confidently face health threats, such as cancer, Alzheimer’s disease, heart disease, diabetes, and mental health disorders, among other conditions.

The United States of Care (USC) released a statement describing the ruling as bringing "peace of mind to those who feared having their healthcare torn away by the courts."

"It is time — especially in the wake of a pandemic — that we put a permanent stop to wielding people’s health care as a political tool or bargaining chip," Natalie Davis, co-founder and acting executive director of USC, said. "Yet another Supreme Court decision in support of the law means that it is time to move beyond these battles and work to create a more affordable, reliable, and more equitable health care system."

The Robert Wood Johnson Foundation (RWJF) said now is the time "for our nation to resume its path toward achieving universal healthcare coverage."

"States that have expanded their Medicaid programs under the ACA have provided health coverage to millions, leading to improved health outcomes and stronger state economies," Richard Besser, MD, CEO of RWJF, said in a statement. "Now we must finish the job to ensure that every person in the United States—no matter their skin color, income level, or zip code—has health insurance and a fair and just opportunity to live the healthiest life possible."

While many stakeholders are celebrating the decision, the Texas Public Policy Foundation (TPPF) feel differently about the Court's decision.

“A decade after the passage of the Affordable Care Act, Americans are still unhappy with the high cost of care, a lack of affordable options, and a system that puts the interests of insurance companies over patients," Director of TPPF's Right on Healthcare, David Balat, said in a statement, "Millions of Americans are eligible for low- or no-cost insurance yet decline to enroll because the system does not deliver the care they need. While supporters of the ACA might cheer today’s decision, the reality is that our system is still in need of repair."

"The good news is states like Texas are beginning to forge their own path and develop new models that provide better help to the uninsured, require pricing information up front, and put patients in charge," Balat continues. "Texas is not waiting around for the Supreme Court to finally recognize the legal problems with the ACA. The failed policy has been evident for more than a decade and Texas is responding with solutions that result in better health outcomes for patients."

Lawmakers weigh in

White House Chief of Staff Ronald Klain tweeted "more Americans are covered under the ACA than at any time since its passage." Additionally, he tweeted "It's still a BFD."

Speaker of the House Nancy Pelosi, (D-Calif.), tweeted her approval, stating that the ACA "endures as a pillar of American health and economic security alongside Medicare, Medicaid, and Social Security."

Former HHS Secretary Donna Shalala tweeted that after the Court's ruling, "Millions of Americans … can breathe a sigh of relief."

New York Attorney General Letitia James, who worked with a coalition including 20 states and the District of Columbia to defend the ACA, said that it is "here to stay."

"For more than a decade, the Affordable Care Act has been the law of the land, providing health coverage and a multitude of protections to tens of millions of Americans across the nation, and today’s decision solidifies those protections for generations to come," James said. "While Republicans have repeatedly tried to take us backwards in time and strip health coverage away from millions, we have now beaten those efforts over and over again and, specifically, three times at the Supreme Court."

Additionally, Sen. Mark Warner, (D-Va.), tweeted: "For the third time, SCOTUS has ruled to leave the Affordable Care Act in place. Without the ACA, 20 million Americans could lose their health care coverage. I plan to continue to work in the Senate to protect our health care."

Julián Castro, mayor of San Antonio was also in favor of the ruling, stating in a tweet that "nearly 1.5 Million Texans have care through the ACA. We should be working to expand, not cut, their coverage."

Additionally, developed an ACA sentiment tracker to monitor the public's sentiment around healthcare reform. The tracker utilizes Twitter's API once a day and analyzes sentiment value from 100 unique tweets.

This is a developing story that will be updated as more information becomes available.

Melanie Blackman is a contributing editor for strategy, marketing, and human resources at HealthLeaders, an HCPro brand.

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