In a landmark decision made yesterday, the Supreme Court upheld the Patient Protection and Affordable Care Act, including the individual mandate, with limitations on the Medicaid expansion provision (find the full opinion here). In a 5-4 decision, Chief Justice Roberts wrote the majority opinion which rested on three main holdings:
1. The individual mandate would have been unconstitutional under the Commerce Clause;
2. The individual mandate can, however, be sustained as a tax under Congress' taxing power;
3. The Medicaid expansion provision can survive review, so long as the states are not penalized with the loss of all Medicaid funding for refusing to comply with the expansion.
Immediately following the decision, hospitals, medical associations, and various advocacy groups have expressed their thoughts, ranging from overwhelming support and optimism to calls for more focused action:
- American Medical Association: "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."
- ACEP President, Dr. David Seaberg: "...while there are provisions in the law to benefit emergency patients, it is clear that emergency visits will increase, as we have already seen nationwide. There are physician shortages and there are also drug shortages and serious mismatches between patient needs and available resources."
- American Hospital Association President, Rich Umbdenstock: "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."
All in all, yesterday marks a historical event in our nation's healthcare history. For more information on yesterday's decision, check out the SCOTUSblog's overview "In Plain English," found here.
- Brittany Baine, J.D.