Hospital officials react to Supreme Court ruling on ACA law

Liz Engel Clark
Friday, Jul 6, 2012

UPPER CUMBERLAND – The United States Supreme Court recently ruled on the constitutionality of the Patient Protection and Affordable Care Act (ACA), and almost instantaneously, several area hospital officials weighed in on the issue.

The justices ruled 5-to-4 that Congress acted within its authority when it required an “individual mandate” for Americans to carry health insurance or pay a penalty by 2014. It also upheld the provision that expands Medicaid to cover about 15 million additional people nationwide by 2019 — including an estimated 330,000 in Tennessee — but said the government cannot withhold all of a state’s Medicaid funding if that state decides not to participate in the expansion.

Cumberland Medical Center

The court’s decision was one Larry Moore, executive vice president, COO and CFO at Cumberland Medical Center in Crossville, expected. There was really no reason to believe otherwise, he said.

“We were already headed down that road and planning as if the act would be upheld,” Moore said. “We’re just moving forward as usual, still focusing on decreasing our costs where we can, focusing on patient-safety programs and continuing to provide good quality of care.”

There is some uncertainty when it comes to Tennessee’s Medicaid roles.
Since the Supreme Court ruled that the individual mandate is really a tax and therefore it is constitutional, “they can do certain things from that aspect that will require people to purchase (insurance),” Moore said, “but they can’t require some states to increase their Medicaid roles,” meaning states may opt out of that version, Moore said.

“States could opt out, and if they do that, there’s still going to be some folks who are uninsured or underinsured,” he said. “What impact that would have is yet to be determined, and I’m not sure how that will all pan out.

“It’s still going to be interesting between now and the (November) election,” Moore said. “There’s benefits in the ACA for people – for individuals with preexisting conditions – there’s a lot of positives. But then you’ve got some small businesses that say they can’t afford to do the program, who say they can’t afford to pay the penalty. So you’ve got people on both sides. It’s a tough decision and our leaders are going to have to continue to tweak it over a period of time, in order to have a win-win.”

Cookeville Regional Medical Center

CRMC is also implementing processes and initiatives to help decrease the cost of care; however, systemic change is imperative, Dr. Menachem Langer, CEO, Cookeville Regional Medical Center, said in a release.

Last year, CRMC provided more than $23 million in charity and uncompensated care. “With basic health coverage for all Tennesseans, hospitals throughout the state will be in a better position to absorb the $4.3 billion in cuts that will be required of them to make reform a reality,” he said.

“Although much work remains to be done on all fronts, we believe that the court’s action is an important step toward meaningful health reform,” Langer said. “Cookeville Regional Medical Center will continue to do our part to provide access to high-quality care for the people of our region.”

Tennessee Hospital Association

The Tennessee Hospital Association (THA), a not-for-profit membership association that serves as an advocate for hospitals, health systems and other health care organizations, celebrated the Supreme Court’s decision. During a conference call with reporters, THA president Craig Becker said nearly one-third of Tennessee’s 154 acute-care hospitals lose money.

Based on the state’s TennCare experience, he said, “uncompensated care will not go away. Coverage for all will certainly be a challenge.”

“We’re very grateful for the court’s decision,” Becker said. “Studies have shown that the insured are much healthier than those who are uninsured, and certainly, in the state of Tennessee, it is a major problem for the providers of health care. It is our Achilles heal in that we have provided $2.4 billion in uncompensated care each and every year and that number keeps growing.

“We plan on working with the governor as we try to figure out the impact of this ruling as we go forward,” he added. “We’re going to need help from Congress, we’re going to need help from the state as we start to transform our field, (in) how we provide care.”

Scott Raynes, chairman of the THA and CEO of NorthCrest Medical Center in Springfield, also took part in the call. He said, “With basic health coverage for all in Tennessee, hospitals are in a better position to absorb the $4.3 billion in cuts that will be required of them under the ACA over a 10-year period. Hospitals will continue to do their part to provide access to high quality care for patients and communities they serve.”

Tennessee Gov. Bill Haslam

“My primary issues with ObamaCare are that it takes away the flexibility for states to encourage healthy behavior, will cost Tennessee hundreds of millions of dollars, and does nothing to solve the crisis of the cost of health care in America,” Tennessee Gov. Bill Haslam said in an emailed statement. “What was unanticipated is the section of the opinion that says states cannot be forced to expand their Medicaid program. This particular portion of the ruling is significant, but it is premature to know the exact ramifications.

“Now it is up to Tennesseans and Americans to turn their attention to the November election,” he added. “By electing Mitt Romney, we can be sure that the entire law will be repealed.”

Congressman Diane Black

“ObamaCare has been a disaster for the U.S. economy,” Black said in an email newsletter. “We’ve had 40 straight months of unemployment above 8 percent with no end in sight. ObamaCare’s regulations, taxes and mandates are killing our economy. And the trillions of dollars in spending ObamaCare adds to our nearly 16 trillion dollar debt is unsustainable.

“I will not rest until Congress repeals the law in its entirety.”