On Thursday, June 28, the US Supreme Court issued its much anticipated ruling on the Obama health reform law. In a 5-4 decision the Court upheld the controversial individual mandate while negating a provision related to the Medicaid expansion. The Court ruled that Congress can enact laws that create and provide for a Medicaid expansion, but it cannot punish states for failure to adopt those expansions. The result is that states would appear to have the option now of implementing the Medicaid expansion or not. In Arkansas, up to 250,000 currently uninsured people would be eligible for Medicaid coverage with the federal government picking up the tab in the first few years. Over time, the state would have to provide 10 percent of the cost.
The AMS issued the following statement after the ruling:
While today’s US Supreme Court ruling clears the constitutional hurdle to implementation of the health reform law, it does not address the shortcomings that caused the Arkansas Medical Society to oppose the legislation in its final form
“The Arkansas Medical Society is, and will continue to be, an advocate for health system reform that makes economic sense, helps patients, and expands coverage,” according to Gene Shelby, MD, AMS President and practicing emergency department physician in Hot Springs
“We applaud efforts to expand coverage of the uninsured and to reform health insurance markets so that our patients can get not only the coverage they need, but the care they deserve. However, we continue to be concerned about other provisions of the Act and more importantly, provisions that were left on the cutting room floor that could have long-term implications for access, ” Dr. Shelby went on to say.
These concerns include:
- provisions in the Act that establish a multitude of new federal regulations and reporting requirements for physicians and other health care providers that remain unproven and impractical;
- a limit on physician ownership of hospitals which eliminates competition and access to facilities that have proven to be not only cost effective but also to provide some of the highest quality of care to be found;
- geographic disparities within the Medicare program that hamper recruitment of physicians and other health care providers to rural states like Arkansas; lack of meaningful provisions to reduce the enormous cost of defensive medicine;
- failure to address the sustainability of Medicare, including the flawed physician payment formula, which continues to reduce senior’s access to medical care;
- the lack of appropriate protections to ensure that patients continue to have a right to choose their physician or to privately contract with their physician of choice.
Now that the Supreme Court has addressed the legal validity of the law, AMS physicians will continue to work with the Arkansas Congressional delegation to seek changes that will help them help their patients.