With Supreme Court Ruling, Big Decisions Ahead for Congress

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With Supreme Court Ruling, Big Decisions Ahead for Congress

This morning, the Supreme Court upheld the Affordable Care Act,  but the really big decision on health care won’t come until late this year in Congress.

The most controversial provision of the law, known as the individual mandate, was affirmed by the court as a valid exercise of Congress’s power to tax. The decision ensures that implementation of state health insurance exchanges can go forward and that millions more Americans will have access to health insurance in 2014.

As important as this decision is, the $7.3 trillion fiscal cliff looming at the end of the year could have even greater impact.  With the sequester and Sustainable Growth Rate provider rate cuts scheduled for January, and continually growing health spending that puts pressure on governments, businesses and families, Congress will have to act on health care.  The question is how.

Some would have the strapped federal government shift more of its costs onto state governments, consumers or providers.  This approach might give the appearance of fiscal responsibility, but it allows hundreds of billions in waste to remain in the health system.  Simply shuffling costs from one budget to another does not help to put our fiscal house in order in the long term.

There is another way. It boils down to a simple principle:  spending our health care dollars wisely. That means taking a look at the third of every health care dollar that isn’t improving anyone’s health.  It means transforming today’s sick care system into a health care system that can fight the rising prevalence and cost of chronic disease.

For this approach to succeed, however, consumers, providers and policymakers each have a part to play. More consumers will have to take responsibility for managing their own health and choosing high-quality, low-cost providers and care. Providers will have to move beyond fee-for-service payments and transition to new, coordinated models of care that deliver better care at lower costs. Policymakers will have to craft viable policy solutions that enhance competition in health care markets, curb waste and fraud in public programs and adjust a range of agriculture, education, taxation and medical liability policies that impact our health costs. 

For all the partisan debate over the Affordable Care Act, leaders in both political parties recognize that the current rate of growth in health spending is unsustainable.  Now that the Court has settled the legal dispute, it is time for Republicans and Democrats alike to come together around common ground strategies that attack waste and ensure all of us are getting the most from our health care dollar.

“The court battle over the Affordable Care Act may be over,” said President and CEO John Rother,  “but when it comes to curbing health costs, the real work has only just begun.”


 The National Coalition on Health Care, the oldest and most diverse group working to achieve comprehensive health system reform, is a 501(c)(3) organization representing more than 80 participating organizations, including medical societies, businesses, unions, health care providers, faith-based associations, pension and health funds, insurers and groups representing consumers, patients women , minorities and persons with disabilities. Member organizations collectively represent – as employees, members, or congregants – over 100 million Americans.Some members of the National Coalition Health Care (NCHC) do not, or cannot, take positions either on specific legislation, strategies or on any policies outside their respective mission areas. However, all that can, do endorse broad policy positions in support of comprehensive health system change.


application/pdf iconJune 28 – Supreme Court Ruling.pdf

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