Another anti-climatic day in Washington, and still no decision from the Supreme Court of the United States (sometimes referred to as SCOTUS) on the constitutional challenges to the Affordable Care Act. But we now know one thing for sure: the decision will be coming out on Thursday, likely between 10 and 11 a.m. EDT—the last day of the court’s session. ACP will review the decision and be ready with a public response within hours, so check this blog for my and ACP’s reaction later in the day. I will also tweet about the decision (@bobdohertyACP) within minutes of the ruling.
In the meantime, I have pulled together the following links to help frame the issues that are at stake, including reprising some of my own blog posts:
--The Washington Post’s Sarah Kliff has a great post that concisely explains the issues being considered by the Court and potential ramifications.
--And, her colleague Ezra Klein has another outstanding post on 11 facts about the Affordable Care Act. With all of the distortions and misrepresentations poisoning the debate, it is good to have someone set the record straight.
--One of the challenges being considered by the Court is whether the expansion of Medicaid is unconstitutional. While the Court won’t be considering the merits of the Medicaid program—it will only rule on whether the federal government has over-reached by requiring states to cover all persons with incomes up to 133% of the Federal Poverty level—a new study shows that when uninsured persons get covered by Medicaid, they see marked gains in their health care. Among other gains, they are far more likely to report having better health and far more likely to have a relationship with a primary care physician than their uninsured counterparts. So much for the policy argument that Medicaid coverage really doesn’t help people get better health care.
--My blog post on what we stand to lose if the Court overturns the entire law. And the chaos that could ensue for physicians and their patients.
Finally, on twitter, @bobdohertyACP, I take on the Heritage foundation over its five reasons why Obamacare is bad for doctors, answering with ten real reasons, supported by real evidence, on why the law is good for doctors and good for patients:
1. Nearly everyone will have health insurance, saving tens of thousands of lives each year.
2. Patients no longer will be denied coverage or charged excessively because of health.
3. Patients and doctors are empowered with better information on the effectiveness of different treatment options.
4: Primary care doctors get more than 11 billion in higher Medicare Medicaid payments.
5: Millions more for scholarships and loan repayment for primary care doctors in undeserved areas.
6: Seniors receive no-cost prevention and wellness exams and reduced drug costs, saving them an average of $20,000.
7: Medicare will pay primary care doctors more for coordinating care.
8. Insurers must spend more on patient care, less on administration, or give rebates.
9: No more annual and lifetime limits on coverage = no one goes broke because of health.
10: Ensuring that everyone has health insurance is the morally, clinically and economically right thing to do.
None of these benefits or consequences may be particularly relevant to the Supreme Court, and people are so dug in on their opinion of the law that facts and evidence may not make a difference in their views. But it is important for all of us to remember what really is at stake for patients and physicians when the Court rules on Thursday—and when Congress, the administration, and voters decide what to do next.
Today’s questions: What do you expect the Supreme Court to do? And what do you think the impact will be?