The June 25 Supreme Court ruling in King v. Burwell brings closure in the latest chapter of legal wrangling over the Affordable Care Act (ACA), and avoids the upheaval that would have resulted if the court had ruled against the federal government. The ruling is significant for commercial payers, whose plan pricing depends on the participation of the young and healthy, and also for providers and patients, for whom the ruling means that business can continue as usual, with eligible patients continuing to receive subsidies to purchase their insurance.
Providers in the 34 states where buyers would have lost their subsidies can now run their businesses with more confidence that their payer mix will remain stable and patient spending will not be negatively impacted. Had the law been overturned, economists projected that the industry would see $7.5 billion in reduced spending.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” wrote Chief Justice John G. Roberts Jr. “If at all possible we must interpret the Act in a way that is consistent with the former, and avoids the latter.”
Steven J. Stack, the president of the American Medical Association, released a statement saying that the association is “relieved” by the decision, and that “with this case now behind us, we hope our country can move forward and continue strengthening our nation’s health care system.”
As always, timely reimbursement from payers will depend on efficient and accurate processes to determine eligibility and manage claims. With those factors under control in the business office, providers can now get back to the work of delivering great care.