Supreme Court Health Care Decision's Impact on Orthotics and Prosthetics

Supreme Court Health Care Decision's Impact on Orthotics and Prosthetics

NAAOP

6/29/2012

Supreme Court Health Care Decision's Impact on Orthotics and Prosthetics

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 over
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
stuck 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 health care 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 health care, 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 (ACO's) 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; and finally,

. O&P Medicare reimbursement will not be thrown into disarray (which would
likely have occurred if the law were struck down).

NAAOP will continue to keep its members informed as developments on this
issue occur.



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