Thoughtful Consideration


Later this month, the U.S. Supreme Court will rule on the constitutionality of the Patient Protection and Affordable Care Act.  Many people feel strongly regarding this issue and generally voice arguments in line with partisan political party viewpoints.  We treat patients, from all political parties, so we strive to focus on treatment and outcomes rather than become involved in political activity.

It is difficult to guess what the decision will be, but a 2009 challenge to the 1965 Voting Rights Act offers a cautious approach to predicting the outcome.  It appeared the justices definitely had serious concerns with Section 5 of the Voting Rights Act based on questions and comments while the administration made its case.  Two months later, the court affirmed the law on an 8-1 vote.

Hospitals throughout America agreed to $155 billion in reimbursement reductions in support of the health care reform legislation.  We also understood that 30 million people would receive coverage as a result of the new law.  If the law is repealed, hospitals would have accepted reimbursement reductions but not received the additional coverage for patients.  This is a critical issue for North Texas where the uninsured represent thirty plus percent of our patients.

Some other bad consequences for patients resulting from the law being ruled unconstitutional are the negative impact of reinstating pre-existing conditions for children, potentially reinstating the “doughnut hole” in Medicare Part D prescription drug program, potential loss of the discounts for brand-name and generic drugs, disruption in enrollment for prescription drug plans, loss of the Medicare free annual wellness exams and other screening services.  Some families with students under age 26 could lose coverage and general disruption to the overall payment system.  The Centers for Medicare and Medicaid Services (CMS) might have to utilize administrative authority or executive orders to pay existing claims or provide benefits which would certainly create political controversy.

Hopefully, the Supreme Court will give thoughtful consideration to this landmark decision regarding an industry that makes up approximately 18 percent of our nation’s economy.  The major guiding principle should not be a legal consideration but rather “what is best for the patient?”