The Bottom Line 

The question is: What do you think about the Supreme Court’s decision on health care reform? Implications?

“The Supreme Court’s ruling removes the cloud of uncertainty under which states, health care providers, insurers, employers and patients have operated since the ACA (Affordable Care Act) was enacted. The law will guarantee access to health insurance for millions of currently uninsured people, which means a flood of new customers for providers and insurers. The ACA will also catalyze the shift of the current health care payment and delivery systems from fee-for-service and provider-centered to value-based spending, patient-centered models.”

Daniel F. Murphy

“I believe that the U.S. Supreme Court’s decision on the health care act was a good thing. I commend President Obama for his stand on this issue and for giving folks protections that are badly needed. Based on estimates, it will not only protect those who are currently uninsured, it will over time, reduce costs and result in a healthier population. I believe that playing political games on the issue of health care will backfire on those who recklessly move in that direction.”

Jere L. Beasley

“It throws a lot of what were long-term financial projections and strategies of companies into flux, especially smaller companies that may have to negotiate between providing the benefits or paying the penalties. I also foresee companies looking to outsource wherever they can in order to reduce the number of employees that they would have to carry the benefits for. A lot of companies are going to have to change how they do business.”

Amy Bolt

“Times are changing. The Supreme Court’s recent greenlighting of ‘Obamacare’ may well fundamentally alter the relationship between employers and employees. Employers may sacrifice growth to stay under the law’s 50-person jurisdictional threshold. Covered employers will have to decide whether they can weather recruitment and retention challenges if they drop coverage and pay the penalty. Employers who continue providing coverage will almost certainly require employees to contribute more. All of these scenarios mark a real crossroads for the long-accepted and expected role of employers to provide robust health care coverage for their workforce.”

Joseph H. Calvin III

“The employer mandate is going to be most challenging for small employers with greater than 50 employees who are not eligible for tax credits, but must decide whether to purchase insurance or pay the $2,000 or $3,000 tax penalty if they do not. Many employers may find it’s more cost effective to pay the fine. The trade-off is losing the favorable tax treatment that employee benefits receive. This may be a difficult decision for many employers.”

M. Paige Powell

“The court’s decision confirms that the health care reform act remains the law of the land for the foreseeable future. Our advice since the enactment is that this is a process and not an event. The regulation writing process continues to define how this law will be interpreted over the next several years. Business owners and individuals should continue planning for higher tax rates in 2013 regardless of the outcome of the November elections. They should also prepare for the continued rise of insurance premiums and deductibles.”

Ross Mendheim

“From the provider perspective, one key takeaway appears to be reimbursement strategy. Providers must continue to determine how best to absorb looming reimbursement cuts and to benefit from the different payment methodologies. However, it remains uncertain whether the anticipated increase in insured patients – through the individual mandate, insurance exchanges and, if Alabama elects to participate, the Medicaid expansion – will benefit providers so they are able to remain financially stable.”

John Lanier

“Although the constitutionality of health care reform is now resolved, significant questions remain as to how the act will be implemented since portions of the law require Congressional funding. Support for funding may be scarce as long as funding translates to tax increases in the view of many Americans. Combined with the uncertainty looming until presidential and Congressional elections in November, answering the question ‘What does the health care ruling mean to me?’ creates a practical conundrum.”

Leslie A. Allen

“The implications for covered employers will be additional time and expense to address health care benefits within their own organizations. Employers may be challenged to reconsider how and when they hire new employees, including the introduction or increased use of contingent and temporary workers to avoid or delay the expense of health care premiums. Like all other employers, staffing companies also must consider how this legislation will impact administrative workloads, client expectations,and their bottom lines.”

Charles R. Baughman

“It seems there are too many people simply communicating the actions of the Supreme Court without a depth of understanding as to the real meaning of all the implications. The outcome of the court’s determination could mean: The federal government cannot penalize states that don’t expand Medicaid; without expansion of Medicaid, the uninsured will still not have access to health insurance coverage; with no access to affordable coverage, these people will now be subject to the penalty tax and hospitals will still provide care to the uninsured so the insured will still be paying for the uninsured. What we will be left with is high health insurance cost and more taxes to pay.”

William F. Hutter

“While I was surprised by the reasoning underlying the Supreme Court’s decision, its implications are clear. Health care providers must continue to focus full attention on complying with the law – particularly the heightened self-disclosure requirements related to the Stark (Law Overpayments) and False Claims Act. Health care reform will continue to be a highly politicized issue in the upcoming election, but for now the decision offers some clarity about the future of the ACA and the obligations under the law.”

Alberto Gonzales

“The Supreme Court declared that the president’s health care law is constitutional, but the ruling does not make it popular. More than half the state governors and the voting population still want the law repealed. They believe it is costly and burdensome to state government and business. A small-business, job-creating enterprise needs to know what government mandated employee benefit plans will cost. Because of the complexity of this massive new government mandate for business and the continued uncertainty surrounding its full implementation, we believe small business job growth will continue to be stalled until after the election.”

W. Hal Shepherd

“The decision leaves many employers in a lurch. They sponsor self-funded health benefit plans that cannot serve as a qualifying coverage under the act, and cannot pass the non-discrimination test that all such plans must pass by Jan. 1, 2014. Rather than pursue a compliance plan, many of them have been sitting back hoping that the court would moot these problems by striking down the act. They find themselves now without a compliance plan in place and have substantial concerns about complying by 2014 or being able to pay the penalty for non-compliance.”

Cavender “Chris” Kimble

“Most of the attention on the Affordable Care Act focuses on the constitutionality of the ‘individual mandate,’ however the act introduced a significant opportunity for health care providers to become actively involved in changing the health care industry through Medicare Shared Savings Programs. Health care organizations are taking notice. These programs are intended to provide better care for individuals, better health for certain medical populations and reduce overall expenditures by eliminating waste and inefficiencies within the industry.”

Cynthia Ransburg-Brown

“I have mixed emotions about health care reform. Being a self-employed business owner, I understand the high monthly cost of insurance, but I also have been seriously injured without insurance and had to pay out of pocket for major surgery. In addition, a friend, who is fighting a terminal illness, has to go round and round with the insurance company that will not cover the cost of the meds. The ethical part of me tells me it is good to have coverage, everybody should, but the business side of me feels it is a bad decision to give any more authority to an entity that is already spending more money than it is bringing in through revenue.”

Joe Batrich