The Supreme Court has spoken, but the debate will probably not end. This morning, the Supreme Court held that the Patient Protection and Affordable Care Act (ACA) is constitutional. Healthcare will, however, be a key issue in the presidential election.
Some of you may remember the discussion of this case on a recent Healthcare Community Call. There were 4 key issues the Court was to consider:
- Anti-Injunction Act
- The Individual Mandate
- Medicaid Expansion
In a nutshell, the Individual Mandate was upheld. Not under the commerce clause as the Administration argued, but upheld constitutionally under the broad taxing powers of the Congress. That, then, essentially addresses the anti-injunction act by saying it is a tax and not a penalty.
Severability is not an issue since the law was upheld. There is no need to pull out or sever pieces of the law from the whole of the Affordable Care Act.
Finally, The Court also clarified that while the Medicaid expansion is constitutional, the federal government cannot withhold existing Medicaid funds from states for non-compliance with the ACA provisions that expand coverage. It is hard for me to imagine a state rejecting the expansion of Medicaid but healthcare is not always about being rational.
So, there will be reams of legal commentary by many people smarter than I about the legal implications of this ruling. There will be much commentary by people who have political and/or pecuniary involvement in ACA continuing or being repealed. I can only tell you how I think this ruling will impact what Symantec does in Healthcare . . . we are the difference between Healthcare and health scare.
In upholding the law, the uncertainty about government programs to advance care coordination in the delivery of healthcare and the move to quality-based payments, supported by health IT, has been removed. The delays and slow-downs in the healthcare provider sector and in State government that we have seen through the first part of this year related to this case have been removed. The ACA is the law of the land.
The issues of privacy, security, compliance and good IT management in healthcare were never at stake. And the regulations around them were never part of the ACA; they are embedded in HIPAA and HITECH, including Meaningful Use. Care coordination and the delivery of healthcare are about data, about sharing data and that will always require protecting that information and managing it effectively and efficiently.
Please let me know if I, or your Healthcare team, can be of further assistance in interpreting this ruling or helping with related customer communications.