On June 28, the National Association for the Advancement of Orthotics and Prosthetics (NAAOP) issued the following update on how the U.S. Supreme Court’s healthcare decision will impact O&P:
The U.S. Supreme Court announced its decision in the Affordable Care Act (ACA) case on Thursday, June 28, 2012. The Court upheld the individual mandate as constitutional based on the fact that the penalty that individuals will be required to pay if they do not have health insurance is a “tax.” Congress has extensive authority to regulate taxes on individuals. The other major holding is that states will have a choice in deciding whether to participate in the Medicaid expansion detailed in the ACA without jeopardizing their existing Medicaid matching funds for their Medicaid population.
There were many ironies and surprises in this decision, which totals more than 125 pages between the majority and dissenting opinions. Chief Justice Roberts joined the liberal block of four justices to render this 5–4 decision, while Justice Kennedy, who was widely expected to be the “swing” vote, dissented along with the conservative block of justices and would have struck down the entire law. Of course, this issue is highly politically charged and Republicans in the House have already scheduled a vote to repeal the entire law for mid-July. This is expected to pass the House but stall in the Senate. Therefore, the fate of healthcare reform moves to the Presidential election, where the American people will decide whether to effectively support or repeal the law through their electoral decision.
From an O&P perspective, there is little that specifically impacts the field. However, there are many regulatory developments and trends that will impact all of healthcare, including O&P:
- ACA regulations are expected to be accelerated, especially the essential health benefits regulation that determines the level of O&P coverage in the state-based exchanges.
- Accountable Care Organizations (ACOs) and other payment bundling mechanisms will pick up speed as these new delivery models are solidified and implemented.
- States’ legislatures and governors will quickly turn to development of their state-based insurance exchanges and the design of their new health insurance markets which will prohibit discrimination based on health or disability status.
- The federally facilitated exchange (which applies in states that choose not to create their own exchanges) will receive significant attention as 2014 nears.
- The medical device tax and other revenue provisions of the ACA will begin to take effect although Congress will continue to find ways to lessen the impact of these provisions.
- O&P Medicare reimbursement will not be thrown into disarray (which would likely have occurred if the law were struck down).
NAAOP said it will continue to keep its members informed as developments on this issue occur.