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Supreme Court Upholds Affordable Care Act

Thursday, June 28, 2012 is certain to be a day for the history books in this country. Yesterday the Supreme Court issued a much-anticipated ruling on the constitutionality of the Affordable Care Act, sweeping health care reform legislation that became law two years ago. Several states argued that the new legislation was not constitutional, and today’s Supreme Court decision brought the spirited debate to a close.

In a majority decision the court ruled that the act is, indeed, constitutional. All of the previously incorporated elements of the act were upheld with the exception of mandatory state participation in the expanded Medicaid program. There are aspects of the law we supported, including health care coverage for more people across the continuum of their lives. By the year 2019 more than 90 percent of all U.S. residents will have access to health care coverage. In fact, citizens who do not obtain health insurance coverage will face a tax penalty.

There will be greater access to insurance as the insurers will no longer be able to place limits on coverage or deny coverage because of pre-existing conditions. And there will be an increased focus on connecting the quality of care with insurance payments, a system that rewards the coordination of care and efficiency.

New delivery systems like the Accountable Care Organization (ACO) Norton Healthcare is helping to pilot will set the standards for eliminating waste and increasing patient safety. The Act also effectively closes what was known as the “doughnut hole” coverage gap in Medicare Part D prescription drug benefits for seniors.

We are specifically pleased that healthcare coverage enhancements for children will be maintained. Coverage benefits in the private market include coverage for pre-existing conditions, coverage for dependents until age 26, preventive care and no lifetime limitations. There will also be new funding for innovation in children’s health care delivery. Though it is unclear now, we hope that temporary increases in rates for pediatricians and pediatric specialists will be maintained so that children have improved access to care.

There are elements of the Act that we felt made a difficult situation even harder to navigate. Chief among them are reduced reimbursements to hospitals and physicians via cuts in Medicare and Medicaid, tax increases to help cover the cost of the program and the overall price tag associated with the program of close to $1 trillion. These costs come at a time when our economy is still recovering from the downward spiral that began in 2008.

We at Norton Healthcare will continue to monitor these developments and build our plans accordingly. Several steps we’ve already taken, such as the investment in the EPIC electronic medical records system and our partnership with Humana to build a model Accountable Care Organization, will give us an advantage as we seek to internalize the many changes we anticipate.

We are fortunate to be in a position of relative strength as compared to other regional health care providers. While others have been focused on complex partnerships and mergers, we have continued to follow the path that has guided us for more than 125 years. We will continue to provide updates as this situation evolves and we have more concrete information to share.

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