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King vs. Burwell

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After ACA ruling, what’s next for physicians


Hear this round-table discussion on  what’s next for physicians after the King vs. Burwell ruling.

Health centers laud ACA ruling

The National Association of Community Health Centers reacted to the Supreme Court’s ruling in King vs. Burwell with this statement:

“{T}he ruling is a victory for Americans and especially for those who depend on health centers for affordable and accessible healthcare. Over half (66 percent) of health centers are located in states in which the federal government operates a Health Insurance Exchange. A majority of the health center patients in those states are low-income and rely on the subsidies to maintain their coverage and options to care.

“We know that many new patients coming to health centers now hold an insurance card for the first time in their lives. Yet, many of them previously delayed seeking the care they so desperately needed, resulting in complex health conditions that could have been prevented with timely access to care. Today is their day. They can keep their coverage and continue to afford life-saving care, whether at a health center or another healthcare provider. Whether or not they should get their care is no longer a choice they have to make. Their coverage now allows them to choose where to get the care they need, and that is good prescription for our nation’s health.

“The Supreme Court ruling affirms what many in the Community Health Center community believe, in both mission and practice: that all people deserve affordable healthcare AND coverage to ensure good health.”

Healthcare execs respond to King vs. Burwell decision

Here’s a sampling of healthcare executives reacting to the Supreme Court’s King vs. Burwell decision upholding a key provision of the Affordable Care Act.

A huge victory for the Affordable Care Act


An estimated 6.4 million Americans get the subsidies in the 34 states that don’t have their own exchanges, with many relying on them to afford their health insurance, says the Department of Health and Human Services.

Some healthcare-insurance experts had warned that  a rejection of the subsidies  would lead to a  surge  in the number of uninsured and the disintegration of the  whole healthcare-insurance law.

The ruling means that the ACA is safe at least through the 2016 and probably far beyond that.

Of course, the ruling is also happy news for  most hospitals and insurance companies, for which the ACA has been a revenue bonanza.

But the problem of surging healthcare costs amidst an aging population seems unlikely to moderate any time soon.


Plaintiff in Scotus case has full government insurance


David King, 64, the lead plaintiff in the case (King vs. Burwell) against Affordable Care Act insurance subsidies, has no worries for himself on healthcare: He has full government coverage as a veteran of the Vietnam War.

Rent a health-insurance exchange


The Illinois Hospital Association says the cash-strapped state  might be able to set up a health-insurance exchange at a lower cost by “leasing” the federal government’s technology, which could appeal to as many as 34 states where a U.S. Supreme Court decision in King vs. Burwell could imperil insurance subsides.

The association also suggests the state could rent from another state that has its own exchange, such as Kentucky’s much admired exchange.

Medicaid expansion: Stark contrast between 2 nearby hospitals

This story about two hospitals — one in Medicaid-expansion Illinois, the other nearby in Missouri, which has not expanded Medicaid — shows starkly how much the  federal money from the Medicaid expansion part of the Affordable Care Act matters to hospitals.

This comes out of a Modern Healthcare magazine’s yearlong analysis of fiscal 2014 finances for hospitals across America  to determine how the ACA’s Medicaid expansion has affected revenue and operating margins. This project is supported by a fellowship from the Association of Healthcare Journalists and the Commonwealth Fund.

This article notes that the “states that have not expanded Medicaid may have the most to lose if the U.S. Supreme Court this month in King v. Burwell strikes down premium subsidies in states using the federal insurance exchange. That likely would cause millions of people to drop their private exchange coverage.  In the hundreds of earnings reports included in Modern Healthcare’s analysis, a number of other themes also emerged: The economy is improving, stronger hospitals are buying weaker ones and hospitals are negotiating better rates from commercial insurers. Those factors are boosting operating margins even without the additional benefit from healthcare reform.”

Video: What Burwell vs. King could mean for physician practices


In this video, Anders M. Gilberg, senior vice president for government affairs of the Medical Group Management Association (MGMA), looks what a decision invalidating health-insurance subsidies would mean for medical practices. He also offers advice to practices on what they can do—regardless of the King vs. Burwell decision—to ensure that they are paid for seeing patients, whatever the patient’s insurance coverage.

Video: The two Americas of healthcare access

How the Supremes, in their King vs. Burwell ruling, could create two Americas of healthcare divided by access to care (even more than now).

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