Community reaction to health care ruling

Staff Writer
Woodford Times

Methodist CEO speaks out in support

There’s no doubt about it. The health care industry has anxiously awaited the Supreme Court opinion upholding or striking down the Affordable Care Act.

Since its passage, our health system, the largest group of health care providers in Iowa, also serving regions in Illinois, has invested millions of dollars in carrying out provisions of the ACA — provisions that have nothing to do with the individual mandate, co-ops or Medicaid coverage expansion. Accountable Care Organizations, bundled payment projects and electronic health records are just a few of the health care delivery provisions of the law in which we’ve invested.

The best kept secret about these provisions is that they embody concepts supported by Democrats and Republicans.

Now that the court has upheld these portions of the law, we breathe a momentary sigh of relief.

Our next reaction is an appeal — to the public, policy makers and political campaign staff: Can we move on? Let’s not have the upcoming election, lame duck session and 2013 Congress focus on ripping apart health care delivery provisions of the ACA that will lower the cost, increase the quality, and improve the patient experience in the health care setting.

As a country we face two incredible challenges: one, to balance the budget and reduce our federal debt; second, to ensure that our private sector companies and their employees can be competitive in a global economy.

Part of the answer to meeting these challenges is figuring out how to make our health care system deliver better outcomes for our patients and be more affordable for all Americans. To do this, we must pay for care differently and clinicians must deliver the care differently.

Physicians, nurses and others across Iowa, Illinois and the country are already working on this under provisions of the law. Iowa Health System and Wellmark have entered into an agreement to do this in many parts of Iowa.

System and Wellmark have entered into an agreement to do this in many parts of Iowa.

In one of Iowa Health System’s regions we established one of the first Medicare Accountable Care Organizations in America — an alliance of a hospital, local doctors, home health care providers and a behavioral health center. Working together, these providers emphasize prevention by encouraging electronic and real-time communications between a patient’s healthcare providers, early-interventions, disease management plans and healthy lifestyle counseling.

This opportunity was provided by the health law. Already it has led to reduced admissions of chronic disease patients to the emergency room and is helping many patients live happier, healthier lives in their own homes.

Another example is the coordination of primary care and behavioral health care into a coordinated care model to keep patients mentally and physically healthy. Of 500 patients in this “community support system,” only 1 percent of them are admitted for inpatient care per month. This is very low for patients with a history of mental illness.

We are already on our way to reforming health care. Let’s not get derailed.

Allowing these types of programs to continue for Medicare and Medicaid patients will result in lower health care costs. Now that these portions of the Affordable Care Act that help in transforming the delivery of care have been preserved by the highest court, our elected senators and representatives must preserve them.

And it is our leaders that can begin bi-partisan efforts to do just that.

In Iowa and Illinois, we are fortunate to have elected leaders with seniority, chairmanship and leadership status, a tenacious record in support of health care. Let’s support them in moving health reform forward rather than backward.

— Bill Leaver is president and CEO of Iowa Health System and Debbie Simon is president and CEO of Methodist Medical Center

Topinka says it will cost state money

Illinois Comptroller Judy Baar Topinka warned lawmakers on Thursday that the Supreme Court’s ruling on the federal Affordable Care Act could lead to hundreds of thousands of new residents enrolling for Medicaid coverage, and cost the state up to $2.4 billion over the next six years.

 The forewarning from the state Fiscal Officer comes after the Court ruled that the federal government can tax residents that do not have health insurance. Given the decision, uninsured residents that qualify for Medicaid are expected to increasingly enroll in the program, and cost the state up to $2.4 billion over six years in the process.

 “There is no doubt that this will cost the state, the only question is how much?” Topinka said. “We have thousands of residents around the state that are eligible for Medicaid but have never enrolled for one reason or another. We expect they will increasingly come forward, and I urge lawmakers to start saving now for those added costs.”

 Medicaid currently accounts for more than 20 percent of the state budget and continues to grow. Underfunded, the program will end the fiscal year June 30 with an estimated $2 billion in unpaid bills. In an attempt to address those realities, members of the General Assembly this Spring voted to limit services and cut an estimated $2 billion from the program.

“Illinois is a textbook example of what can happen if financial challenges are not proactively addressed,” Topinka said. “The state needs to learn from experience, and take steps today to address the increased Medicaid costs that will occur in coming months and years.”

— Judy Baar Topinka, Illinois Comptroller

Kirk wants ‘common sense’ over law

“While I respect the Court’s decision, the health care law threatens our economic recovery by raising taxes, imposing new regulations and creating a drag on the economy,” said Senator Kirk.

“Congress should repeal the health care law and replace it with common sense, centrist reforms that give Americans the right to buy insurance across state lines and expand coverage without raising taxes, while blocking the government from coming between patients and their doctors.”

— U.S. Sen. Mark Kirk R-IL

ACS supports upholding of vote

The U.S. Supreme Court today upheld the constitutionality of provisions of the Affordable Care Act that are critical to ensuring that people with cancer and other life-threatening chronic diseases can access quality, affordable health care.

The decision ensures that critical patient protections benefitting cancer patients and survivors will be implemented, such as those prohibiting insurance companies from denying coverage to people with a pre-existing condition, requiring insurers to provide consumers with easy-to-understand summaries about their coverage and requiring health plans in the individual market to offer essential benefits needed to prevent and treat a serious condition such as cancer.

“The ruling is a victory for people with cancer and their families nationwide, who for decades have been denied health coverage, charged far more than they can afford for lifesaving care and forced to spend their life savings on necessary treatment, simply because they have a pre-existing condition,” said John R. Seffrin, PhD, CEO of the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network.

The ruling preserves vital provisions that are already improving the ability of people with cancer and their families to access needed care by ensuring that proven preventive services such as mammograms and colonoscopies are offered at no cost to patients, eliminating arbitrary dollar limits on coverage that can suddenly terminate care and prohibiting insurance companies from unfairly revoking coverage when a person gets sick.

In Illinois, and in every state across the country, patients will have access to an online marketplace, or exchange, where they can easily compare quality health plans and choose the one that is best for them and their families.

ACS CAN is reviewing the Court’s ruling on Medicaid, but is concerned that the decision may limit the expansion of quality coverage to some of our nation’s most vulnerable citizens. Hopefully the decision will ultimately ensure access to quality health coverage through Medicaid for all low-income and disabled Americans with cancer or at risk for cancer. In Illinois, an additional 631,024 people could be newly eligible for Medicaid enrollment. For many hard-working Americans who have lost their health insurance because they are too ill to work or who have exhausted their savings, Medicaid coverage will provide critical access to proven preventive services and lifesaving treatments.  

 “Access to care saves lives. Scientific research from the American Cancer Society has shown that people without health coverage are more likely than those with private insurance to be diagnosed with cancer at its more advanced stages and less likely to survive the disease,” said Katherine L. Griem, M.D., president of the American Cancer Society’s Illinois Division.

“Now that the Supreme Court has ruled, it is time for all of our elected officials in Illinois to work together in a bipartisan effort to implement the health care law as strongly as possible for cancer patients, survivors and their families.”