US Supreme Court Upholds Health Care Reform Law

AOA and AACOM Issue Statements

By a vote of 5-4, the United States Supreme Court, today (June 28), upheld the Patient Protection and Affordable Care Act (PPACA), including the individual mandate provision, which was considered the most controversial aspect of the bill.

The Court based its ruling on the power of Congress to tax, saying the penalty for not purchasing health insurance is a kind of tax that Congress can impose. It was widely expected that the Court would base the constitutionality of requiring individuals to purchase insurance on the power of Congress to regulate commerce between the states. 

The Court also found that the law’s expansion of Medicaid can move forward, but ruled the federal government may not withhold a state's existing Medicaid funding if the state declines to comply with the expansion.

Chief Justice John Roberts and Justices Stephen Breyer, Ruth Bader Ginsburg, Elena Kzgan and Sonia Sotomayor voted in favor of the law; the Chief Justice wrote the opinion.  Click here to read the full AOA analysis of the Supreme Court ruling on the Affordable Care Act (ACA).

The following statements were issued by the American Osteopathic Association and the Amiercan Association of Colleges of Osteopathic Medicine in response to the decision:

Statement on the Supreme Court Ruling on the Affordable Care Act, by Martin S. Levine, DO, President, American Osteopathic Association
The American Osteopathic Association (AOA) believes that significant strides have been made to improve the nation’s health care system and ensure that millions of patients have access to quality health care—and much work remains to be done in this regard. We remain committed to promoting the critically important role of primary care physicians and continuing efforts to develop and expand patient-centered models of care, which place greater emphasis on continuous, comprehensive and coordinated care, such as the patient-centered medical home and accountable care organizations (ACOs). Our efforts to both improve the delivery of quality care to our patients and ensure appropriate payment for services will continue. We remain hopeful that progress can now be made towards the full repeal of the systemically flawed sustainable growth rate (SGR) formula and the enactment of comprehensive medical liability reforms.
The AOA stands ready to work to ensure the highest quality care for all patients and to work with Congress and the Administration to continue to improve the nation’s health care system. Through collaboration, we can advance policies that increase access to care, improve the quality of health for patients, and achieve reduced costs for individuals and payers.

Statement  by Stephen C. Shannon, DO, MPH, President and CEO of the American Association of Colleges of Osteopathic Medicine

The American Association of Colleges of Osteopathic Medicine (AACOM) applauds the U.S. Supreme Court 5-4 decision to uphold the Patient Protection and Affordable Care Act (ACA).

By upholding the mandate, the Court did not need to decide what other parts of the ACA were constitutional, except for a provision requiring states to comply with new eligibility requirements for Medicaid or risk losing their funding. The Court upheld the constitutionality of that provision so long as states would lose only new funding for non-compliance, not all of their Medicaid funding.
The upheld law contains many provisions that AACOM believes are vital to ensuring that all Americans have access to the high-quality, affordable patient care they deserve.  Given current physician workforce shortages and the additional 32 million currently uninsured Americans who are expected to become insured under the ACA, AACOM has strongly supported and continues to support numerous ACA provisions that are aimed at ensuring a physician workforce that meets the needs of the 21st century.

Graduate Medical Education and Addressing Workforce Shortages
AACOM believes that addressing physician workforce shortages, especially primary care physician shortages, is critical to the nation’s health and well-being, and that providing a sufficient number of graduate medical education (GME, or medical residency) training positions is vital to mitigating such shortages. AACOM supports such programs as the Health Resources and Services Administration’s (HRSA) Teaching Health Center (THC) GME program, which was created by the ACA to provide funding to establish newly accredited primary care residency programs, or to expand existing programs. This program will help in expanding the number of primary care physicians, particularly in underserved, high-need areas. This program also aims to promote GME opportunities for the nation’s growing number of medical school graduates.

Title VII
AACOM supports the ACA reauthorization and revision of the Title VII health professions training programs, which aim to increase the health professions workforce and workforce diversity. The Primary Care Training and Enhancement Program is just one of the critical programs included in Title VII; also included are the Area Health Education Centers, Geriatric Education Centers, Centers of Excellence, and Scholarships for Disadvantaged Students.

Scholarship and Loan Repayment Programs
AACOM supports the ACA’s enhanced funding for the National Health Service Corps, along with other scholarship and loan repayment programs aimed at recruiting and retaining an adequate health care workforce in areas of greatest need.

Rural Physician Training
AACOM supports the rural physician training grants authorized by the ACA. If funded, this program would provide grants for medical schools to recruit and train medical students to practice medicine in underserved rural communities.

National Health Care Workforce Commission
AACOM believes that additional resources should be devoted to ongoing health care workforce data production, analysis, and oversight to assure appropriate investments in the future. With the creation of the National Health Care Workforce Commission, which will make recommendations to Congress and the Administration on health professions workforce goals, priorities and policies, the Commission will help national leaders continue to focus on health professions workforce trends.  AACOM supports the creation of the Commission and the funding still needed for the Commission to begin its work.

Health Care Research and Innovation
The ACA includes several provisions aimed at supporting health care research and innovation, including the creation and funding of the Patient-Centered Outcomes Research Institute (PCORI). PCORI was created as a non-governmental entity to fund patient-centered outcomes research that would give patients and those who care for them the ability to make better-informed health care decisions.  PCORI recently released its first primary research funding announcements, which will provide $120 million this year for innovative projects.

AACOM supports the law’s creation of the Centers for Medicare & Medicaid Services’ (CMS) new Center for Medicare & Medicaid Innovation (CMI).  The CMI will investigate methods to deliver high-quality, cost-effective health care through Medicare and Medicaid, including the development of patient-centered medical homes, promotion of care coordination through salary-based payment; community-based health teams to support small-practice medical homes; use of health information technology to coordinate care for the chronically ill; and salary-based payment for physicians.

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