MHA joined 32 other state hospital associations last Wednesday in filing an amicus brief with the U.S. Supreme Court to defend the Affordable Care Act (ACA).
In December, the Fifth Circuit Court of Appeals ruled that the ACA’s individual mandate provision was unconstitutional. A coalition of states, including Massachusetts, is contesting that ruling and the hospital association brief last week supports the pro-ACA coalition. Also at issue is the “severability” of the individual mandate from the entire ACA. The ACA critics argue if the individual mandate is unconstitutional, then the entire ACA must be scuttled. ACA supporters, including MHA, endorse severability, meaning that even if the individual mandate falls, the voluminous other parts of the ACA should survive.
The amicus brief focuses on the “lesser-known but equally important provisions” of the ACA that have “foundationally changed the U.S. health care system.”
“The ACA’s ‘delivery reforms,’ which the Fifth Circuit and the district court did not mention in their opinions, transformed the way hospitals and health systems deliver and are paid for health care,” the hospital associations stated in a brief written by the Washington, D.C. law firm Zuckerman Spaeder. “These reforms make fundamental improvements in the quality and coordination of care and have become integral to the delivery of health care services in the United States during the almost ten years since the ACA was enacted.”
The associations argue that hospital investments in alternative payment models, readmissions and infection reduction strategies, among other innovations were all undertaken as a result of ACA mandates and are now at risk.
“Unless this Court grants certiorari and resolves the constitutionality and severability questions presented here, the valuable reforms designed to improve health care and lower cost will hang in limbo for several years,” they wrote. That uncertainty will, in turn, disrupt coverage of citizens, quality programs, hospital finances, bond ratings, and investments in facilities, among other deleterious effects.