Does Obama's Re-election Mean Smooth Sailing For ACA?
By Ken Congdon, Editor In Chief, ken.congdon@jamesonpublishing.com
Follow Me On Twitter @KenOnHIT
President Obama’s re-election may have erased the threat of full repeal of his healthcare reform law vowed by Mitt Romney, but that does not mean the controversy surrounding the Affordable Care Act (ACA) is a thing of the past. While the election results have ensured the continued rollout of the healthcare reform law, several elements of ACA will undoubtedly be hotly contested and debated in the weeks and years to come. It’s almost certain that the U.S. House of Representatives will press for concessions in the law, and I’d be surprised if a few weren’t granted.
Most pressing is the November 16 deadline in which states must submit their plans regarding health insurance exchanges. By this time, state leaders are supposed to decide whether or not they will establish their own subsidized health insurance exchanges (HIX) for their constituents to shop for affordable coverage. If they do not, the federal government will create an HIX for them. Governors and legislators in as many as a half-dozen Republican majority states including Florida, Texas, and Louisiana have openly opposed these plans and have refused to act on them. Other states may find themselves ill-prepared to hit this deadline because many shelved their HIX plans during the Supreme Court hearings and the election because of questions surrounding the longevity of the law. Now, many states will likely need to partner with the federal government to have an HIX ready by 2014 unless an extension is granted. The House is also expected to urge the Obama administration to scale back its planned expansion of Medicaid as part of ACA during its negotiations to cut the federal deficit later this month.
However, not all ACA opposition will come from the states and their representatives. As many as two-dozen lawsuits have been filed against healthcare reform by religious institutions looking to overturn the requirement for church-affiliated organizations to cover birth control expenses for their employees. It’s likely that we will see an increase in the number of lawsuits against the ACA as the President enters his second term.
What About Health IT?
Obama’s re-election was also widely viewed as a win for the continued progress of health IT and its government-funded incentive programs. Many believed that the EHR Meaningful Use incentive program launched as part of the HITECH (Health Information Technology for Economic and Clinical Health) Act would be a prime target for fiscal cuts if Governor Romney was elected. Now, most feel the incentive program will remain intact, continuing to entice healthcare providers in the U.S. to implement and use EHR technology. However, some experts warn that these funds could still be threatened by what’s become widely known as the “fiscal cliff.” This term is used to describe the challenge the U.S. government will face at the end of this year when the terms of the Budget Control Act of 2011 are scheduled to go into effect. It is speculated that more than 1,000 government programs are in line for deep cuts during this period in an effort to reduce the deficit. Eliminating the Meaningful Use incentive program may be viewed as a relatively easy cut during this process, considering that these funds aren’t already allocated or promised to particular providers or institutions. However, since the funds allocated to the Meaningful Use incentive program are designed to be recouped by the money the government will receive in the form of penalties from those that don’t comply with the program, there’s also a good argument for why the incentive program will survive the fiscal cliff conundrum. We’ll find out soon enough.