Waiting for Supreme Court Decision – Challenging Time in Healthcare

Editor’s Note: The following post was co-authored by Nancy Hicks, Senior Vice President, Associate Director, North America Healthcare Practice. For more information on potential Supreme Court outcomes, you are invited to join a special webcast Ketchum is hosting on June 20 at 12:30 ET.

For health industry communicators, this is a
spring of high anxiety as the fate of the Affordable Care Act (ACA), the biggest piece of social legislation since Medicare, rests with nine justices on the Supreme Court.  That the ACA landed here is hardly surprising given the political controversy surrounding the law and mixed rulings in the lower courts.  While the healthcare industry is holding its collective breath about the Supreme Court decision, major players are moving forward in implementing key parts of the law. 

If the Supreme Court strikes down all or part of the ACA, there will be profound consequences for the healthcare industry as well as for employers and government agencies that have already invested billions of dollars preparing for the new benefits to take effect. The following two Supreme Court decision scenarios would have a tremendous impact on numerous stakeholders.

• Scenario #1: The individual mandate is struck down and the rest of the law is kept intact. Under this scenario there could be major health insurance disruptions. This would create a situation where there is no mandate for everyone to obtain coverage, yet insurance companies will still have to cover all people regardless of individual characteristics or health status. This will encourage people to get insurance only when they get sick – the resulting insurance pool of sick people could make costs skyrocket for all.
  
  
• Scenario #2: The entire law is ruled unconstitutional. Since parts of law have already gone into effect and money has been spent, striking the entire law would lead to turmoil. Though some key provisions don’t go into effect until 2014, many already have including coverage for adult dependents up to age 26 and coverage of preventive services to customers with no co-pay or deductible.
  
  
• Scenario #3: The Supreme Court could also uphold the law. If this happens, the law’s implementation would continue unabated. States that have waited for the Court’s decision would start moving on exchanges and essential health benefits.  Upholding the law would certainly raise the stakes of the November elections. Should Democrats hold the Senate and/or President Obama win reelection, it’s likely the law would be permanently ensconced. On the other hand, should Republicans control the House and Senate and Governor Romney win the presidency, we can expect that they will try to repeal the law or gut it through budget reconciliation before major provisions take effect in 2014.

The bottom line is there will be winners and losers in the Supreme Court’s high stakes decision, both from a political sense but also from a real world standpoint as many people without health insurance will continue to struggle. Many of the policy elements of reform may survive the political and legal maelstrom.  Helping organizations pivot to an accelerated implementation of the law, or navigating new terrain if the law is not upheld, will present many challenges for communicators in the months ahead.

For more information on potential Supreme Court outcomes, you are invited to join a special webcast Ketchum is hosting on June 20 at 12:30 ET. Former CMS Administrator Tom Scully, former Senator Blanche Lincoln (D-AR) and Chairman of Capitol Health Group Mike Bromberg will share their perspectives on how the decision will impact stakeholders and discuss what each of the potential decisions will mean for the healthcare system, the economy and the country leading up to the November elections and beyond.