In response to the United States Supreme Court’s decision to uphold the individual mandate of the Patient Protection and Affordable Care Act, Dr. David Seaberg, president of the American College of Emergency Physicians (ACEP), today issued the following statement:
 
“The nation’s emergency physicians fully support the emergency care provisions in the law, such as inclusion of emergency services as an essential part of any health benefits package and the prudent layperson standard, which guarantees that health plans base coverage on the patient’s symptoms, not the final diagnosis. And regardless of the Supreme Court’s decision, it does not change the mission of emergency physicians. We pledge to be there for our patients.
 
“However, 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. 
 
“The need to shore up our nation’s emergency departments is as urgent as ever. People come to the ER because they are sick, because they need help, because they feel – according to a recent CDC report – that ‘only a hospital could help.’ A recent study in Annals of Emergency Medicine shows that crowding in emergency departments is growing twice as fast as the rate of ER visits, principally because emergency patients are showing up sicker and with more complicated health problems.
 
“As the nation moves forward with implementing the health care reform law, we urge the Senate to follow the lead of the House in repealing the Independent Payment Advisory Board, which was included in the law. The IPAB panel does not have any accountability to Congress, health care providers or the public and will harm Medicare patients’ access to medical care.
 
“Medicaid is intended as one of the means of expanding coverage. Increasing the number of patients on Medicaid without an equivalent increase in the number of physicians willing to take that insurance will surely increase the flood of patients into our nation’s ERs. Coverage does not equal access and critical problems facing emergency patients are not going away.
 
“ACEP has worked with — and will continue to work with — members of Congress to find solutions to improve the safety and efficiency of emergency care for all Americans. ERs are a critical, life-or-death part of our health care system and ERs need help now. This crisis in emergency care is everyone’s problem, because every person is only one step away from a medical emergency.”
 
Dr. Seaberg adds that this law also includes medical liability dispute resolution alternatives, but that the scope is extremely limited, which limits its potential effectiveness. America’s medical liability system is broken and without true medical liability reform, patients’ access to lifesaving care will continue to suffer.


Palm Beach County Medical Society (PBCMS) President Jack Zeltzer, M.D., released the following statement today regarding the Supreme Court’s decision on the Patient Protection and Affordable Care Act (PPACA):
 
“Now that the Supreme Court has made its decision on the PPACA, PBCMS must work within the framework to continue doing what we deem to be right. Palm Beach County’s physicians will continue to ensure that our patients have access to quality, affordable health care delivered by the physician of their choice. PBCMS is also committed to the preservation of physician autonomy as a main pillar in support of proper patient care. Additionally, we will continue our work to eliminate fraud and waste in the health care system.  It is critical to address these issues now so that patients can receive the first-class care they deserve and so that physicians can provide that care in a patient-focused, cost-effective way.”


The Council of Smaller Enterprises (COSE) has released the following statement on the heels of today’s Supreme Court ruling upholding the Affordable Care Act (Healthcare Reform).
 
“Our members share opinions on both sides of this law, depending on their size and their personal situation. As an organization, our focus has been to direct attention to the need to reduce the cost of health care, the inclusion of more people in the health care system, the creation of a widely available and accessible basic benefit plan, and the connection of consumer behavior and availability of information to decision making in health care. The ruling by the Supreme Court today addresses some of these issues.
 
With nearly 40 years of experience in small business health care, COSE understands the challenges small businesses face accessing insurance. The law works to address this issue, which is a step forward. However, true progress can only be made if we address the cost of care and the resulting cost of health insurance to small businesses and their employees. Now that we have a clearer direction, COSE looks forward to continuing its advocacy efforts and acting as a voice and resource for small business.”


The National Health Law Program (NHeLP) today welcomed the Supreme Court’s decision upholding the Affordable Care Act, including the Medicaid expansion. NHeLP expressed concern, however, about the Court’s limitation on the Medicaid expansion.
 
"We are thrilled that the Affordable Care Act has been upheld," said NHeLP executive director Emily Spitzer. "The law makes health care insurance affordable and accessible for the more than 50 million people in our country who are uninsured today and ensures that more people can access quality preventive services."
 
"I am delighted that states will continue to be able to extend health care coverage to very low income adults through Medicaid —- and with 100% federal funding," said Spitzer. "States should want to participate in this program. Not only is it fully funded by the federal government, but it is a really good program that protects their most vulnerable populations. The failure of a state to participate can only be deemed political."
 
NHeLP disagrees with the plurality of the Court that found that the Secretary of HHS may not use the long-standing authority provided in the Medicaid Act to terminate federal funding to a Medicaid-participating state that does not want to follow the Medicaid rules —- including those for the expansion. NHeLP defended the ACA’s Medicaid expansion in an amicus brief before the Supreme Court that was joined by 38 prominent consumer and provider organizations.
 
"While we are pleased that the Court’s ruling preserves existing Medicaid coverage, we are worried that the low-income people in any state that may reject the Medicaid expansion will bear the costs of that decision. If a state chooses not to participate in the expansion, poor people will suffer," said NHeLP legal director Jane Perkins.
 
"As a practical matter, the Court’s decision doesn’t have to have a significant impact on the Medicaid program," said Sarah Somers, an NHeLP attorney who helped draft the two amicus briefs that NHeLP filed in the case. "The federal government actually has rarely —- if ever —- exercised its authority to withhold all of a state’s Medicaid funds. The Court has limited the size of the federal government’s stick, but it wasn’t a stick the government had ever used."
 
"We continue to hope and believe that most states will take advantage of this remarkable opportunity to extend health care coverage to those in their states who most need it and are least able to afford it," said Spitzer. "To do otherwise would be unconscionable."
 
NHeLP is continuing to review the opinion and will be providing substantial analysis and state-level support in the days and weeks to come.
 


National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey, RPh, MBA, issued the following statement regarding the U.S. Supreme Court ruling on the health care reform law – the Patient Protection and Affordable Care Act:
 
“America’s health care system should be less costly, more efficient and drive better outcomes for patients. Pharmacists have shown, when properly utilized, that the aforementioned principles can be achieved through the medication counseling and other services they provide to millions of patients. During the health care reform debate NCPA played a constructive role in offering recommendations for provisions that could improve the care independent community pharmacies offer, with a premium being placed on maintaining access.
 
“We strived for more coordination with health care providers across the spectrum; reforms that embrace the free market ethos of fairness and transparency; reimbursement levels that take into account budget constraints for payors and are financially sustainable for providers; and ensuring that successful programs are embraced further. NCPA and its members will continue to work closely with Congress and the White House, in a bipartisan fashion, to offer common-sense solutions for the challenges we face for the remainder of this year and in the future.
 
“The health care reform law that was upheld by the Supreme Court includes bipartisan provisions intended to achieve reasonable reimbursement for Medicaid generic prescription drugs, although the implementation process to date has been disappointing. There are also transparency requirements for pharmacy benefit managers in the health care exchanges set to launch in 2014. Medication therapy management will be expanded in Medicare. Independent community pharmacies remain exempted from the duplicative accreditation requirement for selling Medicare Part B durable medical equipment. Mechanisms have been put in place for the inclusion of pharmacies in Accountable Care Organizations and Medical Homes. In the aftermath of the Supreme Court decision and the government’s response to it, NCPA will continue to prioritize these issues because, left unaddressed in a prudent fashion, it is patients that will suffer the consequences. ”