Health Reform Law Upheld

By Jennifer Larson, contributor

June 28, 2012 - After a long, anxious wait for people in support and in opposition, the Supreme Court handed down its decision this morning on the Affordable Care Act.

The verdict: the court upheld the landmark federal law, including the controversial “individual mandate” that requires individuals to have health insurance or pay a penalty.
It was a close decision: a 5-4 verdict, with Justices Sonia Sotomayor, Stephen Breyer, Ruth Bader Ginsburg and Elena Kagan and Chief Justice John Roberts voting in the majority to uphold the law.
The justices in the minority wrote in a dissenting opinion, "The federal government does not have the power to order people to buy health insurance.”

Kaiser Health News reported earlier today that the decision will keep intact the portions of the law that require “insurers to accept all customers regardless of their health status, provides tax credits to those who need help to buy coverage [and] fines some employers who don’t offer insurance…” Those provisions will take effect in 2014.

But the court did not accept a provision that would have required states to comply with new eligibility requirements for Medicaid or risk losing their funding. It limited the federal government’s ability to penalize states that don’t comply. The states will only have to comply with new requirements.

Reactions from nursing organizations

A number of health care organizations immediately reacted to the news--some with pleasure, some with dismay, and some with mixed emotions. Here is a sampling of some of those reactions:

A longtime supporter of the health reform law, the American Nurses Association (ANA) released an announcement that applauded the court’s decision to uphold the law for many reasons, including additional opportunities for registered nurses. The ANA was one of the organizations that filed an amicus brief with the court in January to support the individual mandate.
“This decision means that millions of people will have access to the basic health care and preventive services that they’ve lacked,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “Instead of getting sicker and developing serious and costly complications because they can’t afford to manage their health conditions, people will get the care they need to recognize problems earlier or avoid them altogether. There will be savings throughout the system.

The National Nurses United also released a statement expressing its satisfaction with the verdict, but went on to add, “The Supreme Court decision should not be seen as the end of the efforts by health care activists for a permanent fix to our broken healthcare system, according to the nation’s largest union and professional association of registered nurses today.”

Reactions from physicians’ organizations

Jeremy Lazarus, M.D. president of the American Medical Association, noted the AMA’s support for health insurance coverage for all people and supported the verdict.

“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,” said Lazarus in a statement. “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 American Academy of Pediatrics (AAP) also noted today that it “stands behind today’s ruling by the U.S. Supreme Court to uphold the Affordable Care Act.”
“Today, the Supreme Court upheld a law that invests in children’s health from the ground up,” said AAP President Robert W. Block, MD, FAAP. “The Academy endorsed the Affordable Care Act because it addresses the same ‘A-B-C’ goals that are entrenched in our mission and in our 82 years of child health advocacy: providing  all children in this country with Access to health care services, age-appropriate Benefits to meet their unique needs, and high-quality, affordable health care Coverage.”

The Academy also endorsed the law in 2010 and filed three amici curiae briefs to the Supreme Court in support of the Affordable Care Act’s Medicaid expansion, individual mandate and the mandate’s severability from the rest of the statute.

A statement from John R. Tongue, MD, President of the American Association of Orthopaedic Surgeons (AAOS), noted that the association will work with Congress to implement the best provisions and will support the repeal of “detrimental provisions.”

The statement said, ““The AAOS recognizes that there are provisions within PPACA that help providers deliver high-value health care services and offer musculoskeletal patients protections against insurance company abuse and educational tools to make better health care choices. However, we cannot overlook provisions like the Independent Payment Advisory Board that threaten the doctor-patient relationship and the administrative burdens within the law that could greatly hinder providers’ ability to deliver quality care by infringing upon exam room time.”

Read the Supreme Court's written decision: