Health Groups Cheer Supreme Court Decision, But ACA Hurdles Remain

The Supreme Court's decision to uphold Affordable Care Act insurance subsidies in all 50 states was greeted warmly by major healthcare associations and by Wall Street. However, the decision in King vs. Burwell also served to reignite debate over the healthcare law, and the challenges that remain 5 years after its passage.

The Supreme Court’s decision to uphold Affordable Care Act insurance subsidies in all 50 states was greeted warmly by major healthcare associations and by Wall Street.

However, the decision in King vs. Burwell also served to reignite debate over the healthcare law, and the challenges that remain 5 years after its passage.

Steven J. Stack, MD, the president of the American Medical Association, praised the ruling.

“The subsidies upheld today help patients afford health insurance so they can see a doctor when they need one and not have to wait until a small health problem becomes a big crisis,” he said, in a press release. “…With this case now behind us, we hope our country can move forward and continue strengthening our health care system.”

That sentiment was echoed by Rich Umbdenstock, the president and CEO of the American Hospital Association, who noted that 6.4 million people could have lost subsidies if the Supreme Court had ruled against the Obama Administration.

“The AHA welcomes today’s Supreme Court decision,” he said. “There are more than six million good reasons for it because it ensures continued access to health insurance subsidies for so many Americans.”

For his part, President Barack Obama attempted to close the book on the ACA controversy, saying “The ACA is here to stay.”

House Speaker John Boehner (R-Ohio) had a different idea.

“[W]e will continue our efforts to repeal the law and replace it with patient-centered solutions that meet the needs of seniors, small business owners, and middle-class families,” he said.

With the question of subsidies now out of the way, many sought to shift the focus back toward continuing challenges in the broader implementation of the law and expansion of healthcare access. A Gallup survey from April found that 11.9% of Americans remain uninsured. While that number is down from its peak of 18% in 2013, it still represents millions of Americans without the protection of health insurance.

In an op-ed at the Daily Signal, a news outlet of the conservative Heritage Foundation, Nina Owcharenko said even with the subsidies, the ACA hasn’t solved the problem of healthcare affordability.

“The law continues to be unaffordable for everyday Americans,” wrote Owcharenko, the director of Heritage’s Center for Health Policy Studies. “Obamacare’s costly insurance regulations have made coverage more expensive.”

Drew Altman, president and CEO of the Kaiser Family Foundation, wrote in The Wall Street Journal that advocates of the health reforms still face significant challenges.

“Meanwhile, although steady progress is being made, significant challenges remain for ACA implementation, including: reaching those who are uninsured, a generally more difficult population to connect to insurance; stabilizing premium increases in the marketplaces as insurers get a better handle on their risk pools; and determining which of the Medicare payment and delivery reform projects implemented under the ACA are working and should be scaled up.”

Henry J. Aaron, a senior fellow at the Brookings Institution, noted that the ACA allows states to apply for waivers beginning in 2017 if they believe they can achieve the goals of Obamacare by alternative means. Thus, he said, King vs. Burwell won’t ends the healthcare debate, but only “spares the nation chaos and turmoil.”

“It returns the debate about health care policy to the political arena where it belongs,” he wrote. “In doing so, it brings a bit closer the time when the two parties may find it in their interest to sit down and deal with the twin realities of the Affordable Care Act: it is imperfect legislation and it is decidedly here to stay.”