• Impact of New Health Care on Medical Providers
  • March 12, 2012 | Author: Matthew A. Karsakow
  • Law Firm: Johnson & Bell, Ltd. - Chicago Office
  • The U.S. Supreme Court set out five and a half hours over three days in March 2012, to hear oral arguments on the Patient Protection and Affordable Care Act, an unprecedented amount of time given that the Court generally hears one hour of argument per case.   Twenty six states have challenged the Constitutionality of the law. They are challenging whether the individual mandate included in the act, requiring certain persons not covered under a health insurance policy to purchase an approved private policy. Those who decline to buy health insurance will have to pay a penalty/tax.  The court has dedicated time to hear issues on the Constitutionality of the individual mandate as well as some states’ challenges to the act’s expansion of Medicaid eligibility.  Clearly, the act has been at center stage among political and legal debate as evidenced by its presence in the news and the significant legal challenges it has faced since its inception.  The act will also undoubtedly have a widespread impact on how insurance companies provide and operate health insurance, employer-obtained insurance and individual approaches to their own healthcare.

    Some of the key components of the act are the prohibition of imposing annual and lifetime insurance coverage caps, limiting the ability of insurers to exclude coverage for certain pre-existing conditions and eliminating deductibles and co-payments for certain “essential health benefits” to be defined by the Department of Health and Human Services.  Additionally, the act expands medical facilities where Medicare is accepted, expands Medicaid coverage and restructures Medicare reimbursements and delivery.  While the implementation of the various provisions will take place gradually over the next several years, assuming the Supreme Court does not strike down some or all of it, one certain implication of the act, if upheld is to broaden the availability and number of people carrying health insurance policies.  The act will increase the number of people with health insurance and expand the scope of health insurance coverage by making less stringent the requirements of Medicaid, imposing a shared responsibility penalty/tax for persons not carrying private insurance, creating health insurance exchanges where insurance policies can be compared and purchased, and mandating that insurance companies provide certain benefits and limiting coverage caps.

    Essentially, the act is attempting to address the rising costs of medical care and to expand access to health insurance to millions of individuals.  One of the goals most certainly is to encourage individuals to seek more regular medical care.  But with more seeking medical providers’care, comes the potential for more medical liability lawsuits.  Conversely, if the act achieves its intended goal of encouraging regular medical care, the severity of the nature and the value of these potential medical malpractice suits could decrease as regular medical care would decrease the potential for high-risk patients and catastrophic injuries particularly in hospital settings.

    See Greg Stohr , Health-Care Hearing Before U.S. Supreme Court Scheduled for March 26-28, available at: http://www.bloomberg.com/news/2011-12-19/health-care-hearing-before-u-s-supreme-court-scheduled-for-march-26-28.html

    See Generally Patient Protection and Affordable Care Act, 124 Stat. 119 (2010).