Responses of Advocacy Groups to Health Care Decision

This post contains reactions from several professional and advocacy organizations to the ruling of the Supreme Court upholding the Affordable Care Act.
Ron Pollack, Executive Director of Families USA: Huge Victory for American Families as Supreme Court Validates Health Reform:

“Today’s Supreme Court ruling is a clear, unambiguous, and complete victory for long-overdue health care reform. It sends an unmistakable message that the building of a better, fairer health care system will continue to move forward. 

“Implementing health reform will provide peace of mind for our families, the peace of mind that comes only when our loved ones are sure to receive the health care they need when they need it. 

“The Affordable Care Act provides such peace of mind by ensuring that: 

No one will be denied health coverage or charged a discriminatory premium due to a pre-existing condition, such as children with asthma or diabetes; 

People with major health problems, like those in car accidents, will be protected against arbitrary lifetime or annual limits in how much insurance companies will pay for needed care;

• Young adults can stay on their parents’ health plans until they turn 26;

• Tens of millions of uninsured people will gain health coverage;

• Seniors will receive significant Medicare improvements, such as preventive care with no deductibles or copayments, and the big gap in prescription drug coverage will close;

• Women will no longer be charged discriminatory premiums; and

• Moderate- and middle-income families will receive tax credit subsidies so that insurance premiums are affordable.

“It has taken close to a century to enact meaningful health reform. Now that the Supreme Court has upheld the law, it will become a living reality for all Americans very soon.” 

Jeremy A. Lazarus, President of the American Medical Association, AMA: Supreme Court Decision Protects Much-Needed Health Insurance Coverage for Millions of Americans:

The American Medical Association has long supported health insurance coverage for all, and we are pleased that this decision means millions of Americans can look forward to the coverage they need to get healthy and stay healthy. 

“The AMA remains committed to working on behalf of America's physicians and patients to ensure the law continues to be implemented in ways that support and incentivize better health outcomes and improve the nation's health care system. 

“This decision protects important improvements, such as ending coverage denials due to pre-existing conditions and lifetime caps on insurance, and allowing the 2.5 million young adults up to age 26 who gained coverage under the law to stay on their parents' health insurance policies. The expanded health care coverage upheld by the Supreme Court will allow patients to see their doctors earlier rather than waiting for treatment until they are sicker and care is more expensive. The decision upholds funding for important research on the effectiveness of drugs and treatments and protects expanded coverage for prevention and wellness care, which has already benefited about 54 million Americans. 

“The health reform law upheld by the Supreme Court simplifies administrative burdens, including streamlining insurance claims, so physicians and their staff can spend more time with patients and less time on paperwork. It protects those in the Medicare ‘donut hole,’ including the 5.1 million Medicare patients who saved significantly on prescription drugs in 2010 and 2011. These important changes have been made while maintaining our American system with both private and public insurers.”

Rich Unbdenstock, President and CEO, American Hospital Association, Statement on Supreme Court Decision of the Affordable Care Act:

Today’s historic decision lifts a heavy burden from millions of Americans who need access to health coverage. The promise of coverage can now become a reality. 

The decision means that hospitals now have much-needed clarity to continue on their path toward transformation. But transforming the delivery of health care will take much more than the strike of a gavel or stroke of a pen. It calls for the entire health care community to continue to work together, along with patients and purchasers, to implement better coordinated, high-quality care. 

Now that the Supreme Court has made its decision, hospitals will continue their efforts to improve the law for patients, families and communities.

Marty Ford, Director of Public Policy for The Arc, For People with Intellectual and Developmental Disabilities, The Arc Reacts to the U.S. Supreme Court’s Decision on the Affordable Care Act:

“People with intellectual and developmental disabilities have been waiting for generations for the insurance reforms put in place by the Affordable Care Act. Today’s ruling removes any doubts that the law Congress enacted should stand and will benefit millions of people with and without disabilities. It ends discriminatory insurance practices and makes health coverage more affordable and accessible – important protections which too many people with disabilities have been deprived of for too long. 

“But the ruling is not perfect for people with I/DD. The Arc is concerned that disallowing the federal government the ability to withhold Medicaid dollars from states that don’t expand their program to cover more of the uninsured might mean that people with I/DD who would have benefitted from the expansion could be left behind. Medicaid is an incredibly important lifeline for people with I/DD, providing health care and long term services and supports. 

“We will carefully watch how states react to this development and encourage our advocates across the country to put pressure on their state leaders to do the right thing and expand their Medicaid program."

Karen Ignagni, CEO, America's Health Insurance Plans (AHIP), Now Is the Time to Turn to Affordability:

“The Supreme Court provided legal clarity, but no one should underestimate the policy challenges ahead. Thursday’s ruling preserves the link between the market reforms and universal coverage. The disastrous experience in states that tried to implement similar market reforms in the absence of universal coverage will not be repeated nationally.
With that uncertainty removed, now is the time to turn to affordability. 

Job No. 1 should be to address provisions in the health-care-reform law that increase costs for consumers and small employers. For example, the forthcoming premium tax will increase the cost of coverage purchased by small businesses and individuals, as well as Medicaid and Medicare beneficiaries with private coverage. The essential benefits and actuarial value requirements will mean that millions of Americans have to buy more coverage. In addition, rating provisions in the law will result in young people subsidizing coverage for others, creating further unintended incentives for them not to buy insurance. Unless they are addressed, the cumulative effect of these and other provisions will result in higher costs and coverage disruptions. 

We must also address the unsustainable rise in medical costs that are burdening families and employers, taking up a greater share of federal and state budgets, and threatening the long-term solvency of our nation’s safety-net programs. Until we confront the nation’s spending issues, the promise of health security for all will remain out of reach. 

While the focus has been on insurance market reform, health plans have been leading collaborative efforts to reform the payment and delivery system to promote prevention and wellness, help patients and physicians manage chronic disease, and reward quality care.”

Jay Timmons, President and CEO, National Association of Manufacturers, Congress Should Act to Replace Health Care Law with More Efficient, Less Costly Reforms:

“Since the beginning of the health care debate, manufacturers have consistently made it clear that lowering costs should be the central focus of any health care reform effort. Ninety-seven percent of manufacturers offer generous health benefits to their employees, and skyrocketing health care costs represent the single biggest obstacle for them continuing to do so. It is clear that the Affordable Care Act did not address this issue and, in fact, will make matters worse. Today’s ruling, although a dramatic moment in our nation’s history, still leaves a lot of work to be done to reduce soaring health care costs. 

Time and again, manufacturers have sought to reduce the cost of health care. Escalating health care costs are job killers, forcing manufacturers to pay more in premiums rather than investing in their business and creating jobs. From the day it was passed, the Affordable Care Act did nothing to bring down health care costs, and it is essential that Congress repeal the law and replace it with reform that benefits manufacturers and their employees.
We will continue to push Congress to implement legal liability reform, enhance competition by allowing insurance to be purchased across state lines and increase the focus on preventive medicine—actions that would address the high health care costs that harm manufacturers across the United States. Washington must work for manufacturing to ensure that health care costs aren’t a roadblock for job creation and economic growth.”

Sara Collins and Karen Davis, Vice-President and President of The Commonwealth Fund, Nation to Move Forward on Ensuring Affordable Access to High-Quality Care for All, excerpt on holding down costs:

The Affordable Care Act includes an extensive set of new demonstration programs and incentives aimed at improving the quality and cost of health care. Such changes include payment innovations, among them, higher reimbursement for preventive care services and patient-centered primary care; bundled payment for hospital, physician, and other services provided for a single episode of care; shared savings for accountable provider groups that assume responsibility for the continuum of a patient's care; and pay-for-performance incentives for Medicare providers. In combination with the insurance market reforms and new revenues, these provisions are expected to more than offset the cost of the coverage expansions. CBO estimates the Affordable Care Act will reduce the federal deficit by $124 billion between 2012 and 2021. David Cutler, Karen Davis, and Kristof Stremikis estimate even greater savings from the law's delivery system reforms than CBO: $406 billion in savings through delivery system reforms in the law by 2019, and consequently a much greater net decrease in the deficit of $400 billion by 2019. The authors estimate that the combination of insurance and delivery system reforms in the law could lower family premiums by $2,000 by 2019. 

Indeed, the current wave of delivery system innovation taking place in states across the country even as the law is being implemented suggests that these larger savings might ultimately be realized. Several patient-centered medical home interventions, both in the Medicaid program and initiated by private payers, have realized significant reductions in hospitalizations and emergency department use. New provider payment arrangements and incentives have slowed spending growth in parts of the country, and a nationwide program to reduce hospital readmissions has already resulted in statistically significant reductions in 30-day hospital readmission rates in Massachusetts and Michigan.

Now that we have taken steps to guarantee universal access to health care for all American citizens, there is a consensus across the spectrum - among patient and family advocates, health care providers, health insurers, and the business community - that it is necessary to turn our attention to making health care more affordable. That is the great challenge we still face. The Affordable Care Act will lower average costs of health care for American citizens but will not reduce total health expenditures, which are still expected to escalate at about the same rate as before - although covering tens of millions more American citizens. It is now necessary to reduce overall spending on health care - and that cannot be accomplished without the dedicated cooperation of all these groups.

Professor Huhn is the author of "ObamaCare: Is It Necessary, What Will It Accomplish, Is It Constitutional?"