Affordable Care Act Special Edition Pt. I: The Impact

The Supreme Court’s recent decision to uphold the Affordable Care Act has ensured that healthcare reform will remain a topic of interest for months and even years to come. In light of the decision – which will impact Main Street, Wall Street, K Street, and all roads in between – this special edition of Health-E Minds shares insights on the road ahead from a variety of perspectives.  Participants in this discussion include Jeff Levine, former CNN medical correspondent; and a number of Ketchum healthcare and public affairs experts.   Additionally, Ketchum recently partnered with the law firm Alston + Bird, LLP to examine potential implications of this decision prior to the Supreme Court ruling; to view a recording of this webcast, click here. 

The first in a three-part series, our panel members address the question: “What is the impact of this decision?”

Joe Wagner, Vice President, Public Affairs,
Ketchum Washington, D.C.: In two words: status quo. The Supreme Court, with its ruling, kept the provisions and benefits of the Affordable Care Act in place. Chief Justice John Roberts, writing for the majority, was likely thinking about his legacy on the court by writing for the majority “when a court confronts an unconstitutional statute, its endeavor must be to conserve, not destroy, the legislation.” Real world translation, with its decision, the Supreme Court upheld hundreds of rules embedded in the law designed to help millions more Americans obtain health insurance.  the healthcare industry is truly being transformed.

Chris Shreeve, Senior Vice President, Practice Lead, Social Marketing, Ketchum Washington, D.C.: Immediately there will be challenges and calls for repeals from the Republicans, and jubilation from Democrats.  How each side will attempt to use the decision to its advantage will be interesting. The government needs to take control of shaping this story and explain the law beyond the popular elements like health insurance for children until age 26 and coverage for folks with pre-existing conditions.  Meanwhile Republicans should connect with voters and sell its own health care agenda because the polls tell us the majority is looking for some kind of change, even if it’s not what the health care law is offering.

The decision will bring that narrative back into the media in full force.  One side will put forward people with pre-existing conditions hailing the law as their lifeline; the other side will trot out average Americans who will argue that the law treads on their individual rights. And that doesn’t even account for the ad campaigns that will be waged for one side or another. One thing for certain, the summer will be full of talk about healthcare reform. 

Nancy Hicks, Senior Vice President, Associate Director, North America Healthcare Practice, Ketchum: The clarity of this decision will come as a relief to healthcare companies that have invested a lot to date but have been tenuous about moving forward with the law, pending the outcome of this decision.  It is now full steam ahead, not only for companies but for states that must have plans in place by 2013.  The cloud of uncertainty that has hung over the law will be removed with the path to implementation more certain.

Jeff Levine, Former CNN Medical Correspondent and Former WebMD Washington Bureau Chief: It would be hard to overestimate the impact of this ruling.  As a practical matter it paves the way for 32 million Americans to gain regular access to health care.  It also shaves many of the rougher edges off of the insurance market like exclusions for pre-existing conditions and lifting lifetime caps on coverage.  Since everyone is a health care consumer, so goes the proponents’ argument, the market is unique.  If healthy people stay out, the costs go up for everyone.  That idea will be put to the test as the Affordable Care Act (ACA) is implemented in the next two years and beyond. 

Medicaid remains a big question.  Expansions in the program are intended to cover an additional 17 million people.  The court said that’s constitutional, but individual states can opt out if they fear the costs are too high.  Many of the twenty-six states that sued the federal government to block the ACA may decide not to enroll those newly eligible for insurance.  Among the anti-ACA plaintiffs were small businesses.  However, they may ultimately benefit as their employees migrate to state insurance exchanges.  Down the road the ACA promises to improve the quality of care by determining which treatments are most cost effective.  Other countries do that but it remains to be seen if it’s possible to bend the inexorable trajectory of health care costs.  Medicare will remain structurally unchanged, but seniors will continue to get a bigger break on prescription drugs.