The U.S. Supreme Court's historic decision to uphold the Patient Protection and Affordable Care Act lifts a heavy burden from millions of Americans who need access to healthcare coverage. The promise of coverage—the cornerstone of any equitable approach to healthcare—may now become a reality for them, their families and communities.
But the decision also leaves it up to each state to decide whether to participate in expanded Medicaid coverage, and that prolongs the uncertainty for a yet-to-be-determined number of people who might have qualified for coverage. Given the significant federal financial support that will be available to states that opt in, we hope that the promise of coverage will be fully realized.
Lack of insurance coverage has consequences for individuals, their families and society at large that go far beyond the obvious—lost health and longevity. It precipitates lost workplace productivity; financial stress on individuals, families and communities; and uncertainty for healthcare providers. The Affordable Care Act is an imperfect law and does not offer coverage to every American, but it substantially increases the number of people who can look forward to enjoying better health and security. It also puts in place delivery system reforms that better align provider incentives to improve care coordination and quality and reduce costs.
In 2008, the American Hospital Association made “Health coverage for all, paid for by all” a lead element in Health for Life, our road map to better, safer, more efficient and affordable healthcare and a healthier America. Other AHA reform goals are a focus on wellness; the most efficient, affordable care; the highest quality care; and the best information.
The court's decision means that hospitals now have much-needed clarity to continue on the path toward transformation envisioned in Health for Life. But transforming the delivery of healthcare will take much more than the strike of a gavel or stroke of a pen. It calls for the entire healthcare community to continue to work together, along with patients and purchasers, to implement better coordinated, high-quality care.
It also calls for cooperation at the federal level. Among the most-pressing challenges still facing hospitals are the high cost of the latest technology, equipment, devices and pharmaceuticals; the struggle to attract and train enough doctors, nurses and other caregivers; meeting the needs of the growing number of seniors and other patients with multiple chronic illnesses; underpayment from government health programs that shifts costs to employers and other patients; providing care for the many patients who remain uninsured or have inadequate health coverage; and complying with increasing regulatory and payer requirements.
As Congress looks for ways to address our nation's debt and deficit, hospitals will support a balanced national strategy and will remind our elected leaders that additional cuts to Medicare and Medicaid funding for hospital services would mean longer wait times for care; fewer doctors, nurses and other caregivers; less patient access to the latest treatments and technology; and a slower transformation of the way we deliver healthcare.