Supreme Court Rules for Burwell in ACA Decision:
What Does it Mean?
Written by Shannon Sakewski
On June 25, 2015, the Supreme Court issued a decision in the case of King v. Burwell which could have eviscerated the Affordable Care Act (ACA). As Health Administration Degrees reported in March, in this case, Justices considered whether the law’s language limits subsidies to only those states with state-based Marketplaces. Since, in 2015, only 14 states offer this type of Marketplace, if the Court had ruled in favor of King, over 8 million people would have lost the subsidies which, for many, makes health insurance affordable.
In a 6-3 decision, the Court ruled in favor of Burwell, ensuring that health insurance subsidies remain available to working class individuals and families across the US. Many parties breathed a sigh of relief including those who would be otherwise uninsured, insurance markets which would have experienced an economic tailspin, and health systems which have seen their uncompensated care costs drop by billions of dollars.
What the ACA ruling means?
This ruling is clearly good news for many Americans, and for the health-related economies in a majority of states. As expected, the ACA has significantly impacted uninsured rates throughout the country. While around 10% of Americans remain uninsured, that is a dramatic decrease from the approximately 18% uninsured in 2013. Ideally, that number will continue to decrease as people understand the benefits of the law and realize that it is, more than likely, here to stay.
Though the ACA has made an impact on access to coverage, the longer-term issues which the law aims to address revolve around the cost of care. Curbing those costs has begun. In 2002, the growth in health care expenditures was 9.6%, while that growth rate dropped to 3.6% in 2013. In 2013, that means that an average of $9,255 per person was spent on health care. Overall, that amounted to $2.9 trillion and 17.4 percent of the gross national product.
There is still a great deal of work to do with regard to curbing the cost of care. What do we do about it, and how does the ACA help with this endeavor? How can you, as a healthcare administrator or healthcare administration student help? The answers to these questions are many. Continuing ACA-enabled Medicare payment reform experiments, such as Accountable Care Organizations (ACOs), is a useful start. At least preliminarily, ACOs appear to be positively impacting the cost curve.
Additionally, research related to understanding what care, and care-related programs work best is crucial. The institutions which primarily support health quality research– the National Institutes of Health (NIH) and the Agency for Health Research and Quality (AHRQ)– experience ongoing challenges to their funding. These challenges may not directly impact the ACA, but they do impact both the overall economics of care, as well as the quality of care for individual patients. (Read more here.)
Where does your institution fall on these issues? Have ACOs been effective where you work, or hope to work? Is health quality research supported at your institution? Tell us about your experiences via Twitter: @healthadmdegree and @ssaksews.
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