Health Care Reform in 2012: Change Is Inevitable, So Embrace It
By Chris Rivard and Karl Rebay (Partners, Moss Adams)
The Patient Protection and Affordable Care Act is two years old. Is it a success? A failure? Has health care been reformed? Is reform on its way? These are but a few of the questions being asked on the second birthday of this monumental and highly divisive legislation. So what’s the current state of play?
Surveys indicate agreement among most Americans that these are some of the good things that have already occurred as a direct result of the act. Many other residual changes are also taking place:
And yet the nation remains divided and confused:
It’s very difficult to draw definitive conclusions from this data. But, like it or not, change is occurring at a very rapid pace, driven primarily by hurricane-force winds of economic reality. Providers need to face these issues, or they may become casualties of the storm. It could also be wrong—even detrimental—to assume that the Affordable Care Act, or any portion of it, will be dismantled.
Here’s why: A new president or Congress won’t be in place before January 2013. Assuming change won’t occur immediately, any proposed alteration of the act won’t likely be made until well into 2013, mere months before the significant provisions of the act are scheduled to take hold and long after many provisions have been put into place at significant expense.
What’s more, the current constitutional challenge to the act is directed primarily at the individual mandate, which is probably ineffective anyway, given the small penalties assessed for noncompliance. And the Supreme Court may be forced to wait until 2014 to rule on the case, thanks to the Federal Anti-Injunction Act, which prevents the court from ruling on legislation before it becomes effective. In addition, as noted above, many of the provisions of the act are viewed positively, and it may be politically damaging to eliminate them.
And finally, if the Affordable Care Act is struck down, there’s currently no substantive or widely acceptable replacement for it—and going back to the status quo isn’t palatable. A recent alternative plan, proposed by Oregon senator Ron Wyden and Wisconsin representative Paul Ryan, is getting some attention, but the political environment is so polarized that it’s hard to predict what will happen, despite this bipartisan effort.
The clear and underlying message in all this? Don’t be a spectator. Don’t wait for things to change. Embrace the change. Regardless of the politics, consolidation and integration are occurring and they won’t stop, even with potential changes to reform laws. There are significant opportunities to improve your organization, to improve patient care, and to improve the United States health care system in 2012 and beyond.
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