The cherry-picking of harsh Supreme Court questions about the Affordable Care Act has fed a misleading impression that health reform is on life support or perhaps already deceased. Here’s the reality -- health reform continues. Virtually every state is now engaged in using federal grants to build state exchanges and expand Medicaid—a process that will persist in some form even if the Supreme Court strikes reform.
The reality on the ground is fuelling reform. Large insurers welcome the opportunity to end freeloading and the new revenue from individual premiums and federal government tax credits to cover everybody. Meanwhile, hospitals are eager to escape from the financial weight of caring for 53 million uninsured Americans, and family physicians and skilled nurses welcome new pools of patients with coverage for needed care without being buried in unnecessary paperwork. And large employers look forward to a day when they won’t be used as a piggy bank to pay for the costs of treating the uninsured—costs that can amount to $1,000 for every employee—and to reimburse medical providers for quality rather than driving up the number of services.
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