Industry and other reactions to the U.S. Supreme Court decision upholding the Patient Protection and Affordable Care Act have been coming in. Readers are encouraged to offer their own reactions in Comments section.
America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni:
“Individuals and families need secure, affordable coverage choices. Maintaining the link between market reforms and universal coverage is essential to avoiding significant cost increases and loss of choice for consumers and employers.
“As the reform law is implemented, health plans will continue to focus on promoting affordability and peace of mind for their beneficiaries. The law expands coverage to millions of Americans, a goal health plans have long supported, but major provisions, such as the premium tax, will have the unintended consequences of raising costs and disrupting coverage unless they are addressed.
“Health plans will continue to work with policymakers on both sides of the aisle to make coverage more affordable, give families and employers peace of mind, and promote choice and competition. Health plans also will continue to lead efforts to reform the payment and delivery system to promote prevention and wellness, help patients and physicians manage chronic disease, and reward quality care.”
Janet Trautwein, CEO of the National Association of Health Underwriters:
“This ruling offers some clarity on the future of the health insurance industry and allows American individuals, families and businesses to adjust to the law. While we still have concerns that PPACA does not address the true drivers of health insurance costs in this country, and the law is having a huge and costly compliance burden on American employers, it is our responsibility as industry leaders to move forward within the constraints of the law to help Americans access high-quality, affordable healthcare.
“There are still legislative actions that can be taken to fix parts of the law, and though we support many of these efforts, our focus is to help our customers transition to the regulations, policies and procedures the law outlines.
“As insurance professionals, our job is to assure full-scale implementation of PPACA will continue and to help our individual and employer clients with the transition and compliance requirements the law entails. Our efforts to enroll individuals in high-risk pools, Medicare, Medicaid and CHIP programs will continue as we work to lower the number of uninsured Americans.
“It is imperative that the Administration and regulatory agencies provide information in a timely manner on the many aspects of PPACA that remain unclear. The changes to pricing and standards of coverage, employer responsibilities, uncertain tax provisions, state exchanges and many other issues must be addressed in a clear and cost-effective manner that provides individuals, families and employers continued access to proven tools that enable agents to provide affordable coverage.
“We look forward to having ongoing dialogue with lawmakers on both the federal and state levels to find solutions that ensure all Americans receive the benefits they deserve at a price they can afford.”
National Federation of Independent Business (NFIB) President and CEO Dan Danner:
“While we are certainly disappointed, NFIB respects the decision to uphold the individual mandate by the Supreme Court. Clearly this mandate has now become a tax on all Americans and a broken campaign promise from President Obama not to raise taxes.
“We are concerned about the precedent that this will set in Congress’ ability to mandate other aspects of our lives, but we will move forward from today to continue to fight, harder than ever, for real health-care reform for our membership.
“Under PPACA, small-business owners are going to face an onslaught of taxes and mandates, resulting in job loss and closed businesses. We will continue to fight for the repeal of PPACA in the halls of Congress; only with PPACA’s full repeal will Congress have the ability to go back to the drawing board to craft real reform that makes reducing costs a number one priority. The power and control of health-care decisions should be in the hands of the consumer, not the government.”
National Federation of Independent Business (NFIB) Executive Director Karen Harned:
“This day will go down in history as the day when Americans lost a part of their freedom – the freedom to choose what they want to buy with their own money.”
Independent Insurance Agents & Brokers of America (Big “I”) President Robert Rusbuldt:
“The Big ‘I’ is disappointed with the U.S. Supreme Court’s decision to uphold the PPACA. Our association, economists and other industry leaders and experts agree that many of the provisions in the PPACA are causing more harm than good. The Big ‘I’ will continue to work with Congress to repeal provisions of the law that negatively impact our small business members and the customers they serve.”
Independent Insurance Agents & Brokers of America (Big “I”) Senior VP Charles Symington:
“The PPACA’s MLR [medcial loss ratio] provisions threaten the livelihoods of health agents and brokers and establish perverse incentives that make it challenging for smaller insurers to enter the marketplace. These MLR requirements have produced cuts in agent compensation of up to 50% in some areas of the country and made it a challenge for many agents to maintain the level of customer service and quality of advocacy traditionally provided at a time when such assistance is needed more than ever.”
National Association of Insurance Commissioners (NAIC) President and Florida Insurance Commissioner Kevin M. McCarty:
“While the NAIC has taken no position on the law, as an organization we have continued our mission of providing information and support to state regulators so that they may best serve their consumers and their markets. We will continue to work to give regulators the tools they need to ensure a stable health insurance marketplace in the states. Where the ACA provides states with latitude, regulators will continue to work with insurers, consumer groups and the public to provide the best regulatory framework going forward.”
J.D. Piro, national practice leader in Health Law Group of Aon Hewitt, benefits broker
“Now that the Court has ruled, U.S. employers will turn to executing the strategies for 2013 and 2014 that they have so far put on hold. In turn, agencies such as the Department of Labor, the Internal Revenue Service and Health and Human Services, will need to work overtime to issue the significant amount of guidance employers need to implement these rules.”
Holly Meidl, U.S. HealthCare Practice Leader for Marsh Inc.:
“Following today’s Supreme Court ruling, hospital organizations will likely move quickly to form accountable care organizations (ACOs) and similar networks.
“In anticipation of the PPACA taking effect, a number of hospitals and providers have banded together to form ACOs and other networks through which they can offer a range of coordinated services to a population of patients. Those that have delayed their pursuit of these networks while awaiting the Supreme Court’s ruling will now move quickly to adapt to the law.
“Even if Congress ultimately repeals all or part of the PPACA, the industry has already gone too far down this road to go back. Government payment structures and cost pressures will continue to force hospitals and providers to pursue ACOs and other such networks.
“Hospitals and physician groups must remain vigilant about managing the expanding risks and exposures associated with operating ACOs. These risks include increased managed care errors and omissions exposures, directors and officers liability exposures, and cyber/privacy risks.”
R Street Institute free market think tank Associate Fellow Lawrence Mirel, the former insurance commissioner of Washington, D.C.:
“While we believe the individual mandate was not properly structured and that Congress should have pursued alternative means to expand health insurance coverage, we also think it promotes individual responsibility for healthcare and was within Congress’ power to create.
“The health care reform genie is out of the bottle and there is no way to get it back in. Regardless of the problems with the Affordable Care Act — and there are many — much of the new law has already been implemented and has created expectations that providers, employers, insurers and users alike rely on.”
R Street Institute free market think tank President Eli Lehrer:
“Although PPACA contained some good ideas — including the exchanges and a move away from employer-provided health care — the medical insurance system still needs improvements and the bill needs major changes. With this ruling, the Supreme court has made it clear that those changes should be made by the people’s elected representatives in Congress.”
Andrew C. Harris, President-elect, National Association of Professional Insurance Agents (PIA National):
“It is unfortunate that the Supreme Court upheld a bill that has been widely criticized by the public and the insurance industry. The nation’s professional independent insurance agents remain committed to providing their customers with professional advice and choices regarding their health insurance. We urge all states to now deal with the issue of insurance exchanges in a manner that guarantees the right of insurance consumers to rely on the expertise of licensed professionals as they make important decisions about their health insurance coverage.”
Adam Bruckman, president and CEO , Digital Insurance, an employee benefits agency:
“While the Supreme Court’s decision about the Patient Protection and Affordable Care Act determined the outcome of one of the most significant judicial cases of the century, no one has yet addressed one of the most pressing issues facing our nation: the rising cost of health care. Our country still does not have measures in place to control a system that is on an unsustainable cost trajectory. If we are to effect meaningful change, we are obligated to devise methods to curb rising expenses.
The solution is a system that produces knowledgeable and engaged health care consumers. This can only be achieved through innovation — not through mandates, regulation and government programs. Evolution must be led by the private sector and requires collaboration between benefits advisors, employers, insurance carriers, providers and consumers.”
Jay M. Kirschbaum, Practice Leader – National Legal and Research Group, Willis Human Capital Practice:
“Employers and their advisors will now continue to move forward with their plans. While the individual mandate was the real question at issue, it really did not fundamentally change the options for employers. The issues regarding employer plans versus individual marketplace for insurance for their employees will still be an issue employers will grapple with. The penalty (or tax as the Supreme Court has now labeled it) is still relatively small and with the hint that taxpayers might just refuse to pay the tax it remains to be seen whether that tax will be enough of an incentive to get taxpayer to purchase insurance (or otherwise seek coverage) in enough numbers to make the insurance reforms work within the context of the private insurance market. If that market does not offer a cost effective alternative to an employer plan (and given the cost impact of the insurance reforms that is not only possible but likely) the employer provided market will still likely offer the best option for most employees.”
Edward Fensholt, JD, principal in Lockton’s Health Reform Advisory Practice and leader of Lockton’s Compliance Services group:
“The health reform train keeps on rollin’. decision didn’t derail the law, or even send it down another track. It’s now ‘full speed ahead’ toward full implementation of the law’s signature provisions in 2014.
“Regulations, particularly on the employer mandate, will be very complex and we can expect a crush of complex guidance compressed into a very short time.”
”Next stops on the health reform train include distribution of four-page plan summaries, W-2 reporting of health plan values, limits on health flexible spending accounts, new income and capital gains taxes on executives. There remains plenty to do.”
Mark Holloway, JD, principal in Lockton’s Health Reform Advisory Practice and leader of Lockton’s Compliance Services group:
“Employers who were sitting on the fence, not entirely embracing all the changes and strategic thinking required by reform, will have to engage…quickly. Employers will need to begin making significant, strategic decisions within the next several months.
“The Court said the feds cannot hold a state’s Medicaid funding hostage, if the state doesn’t play, That might mean more people seek subsidized coverage in an insurance exchange or—worse—that some folks will qualify for neither Medicaid coverage nor exchange-based subsidies.”
Florida Gov. Rick Scott, a Republican:
“Today’s decision by the Supreme Court of the United States is simply disappointing. The tax question was repeatedly refuted by members of Congress who helped pass this health care takeover. The Justices have declared that the central provision of ObamaCare is a judicially mandated tax. A new tax pure and simple. This is just another burden the federal government has put on American families and small businesses.
“With the national economy struggling to recover, now is not the time to implement a massive social program that injects nothing but uncertainty and doubt into our economic system. By doing so, they have put up yet another major roadblock to efforts to get people back to work and forced the government into the important relationship between patients and their doctors.
“I stand with Justice Kennedy that the entire act should have been held invalid.”
New York Attorney General Schneiderman, a Democrat:
“The Supreme Court’s decision to uphold the Affordable Care Act is an historic victory for the tens of millions more Americans who will be covered by health insurance. The law’s effects will be significant in our state, where over two million people are uninsured. Over a million uninsured New Yorkers will soon have access to affordable coverage. This law will continue to provide a spectrum of key consumer protections including keeping young adults on their parents’ plans, ending pre-existing condition restrictions, and increasing consumer information about health care choices. My office stands ready to enforce the Affordable Care Act to ensure that all New Yorkers will benefit from the law’s protections.”