Key provisions of Patient Protection and Affordable Care Act were substantially upheld today by the Supreme Court, including the individual mandate.With the entire ACA left intact, Colorado’s efforts to improve care and reduce the cost burden gain new energy. And the Center for Improving Value in Health Care’s (CIVHC) initiatives to transform our health care delivery and payment systems now rest on a stronger foundation.
The Court’s decision to uphold the individual mandate for insurance purchasing is particularly important. Bringing everyone into the insurance pool with the individual mandate is the only way you can spread risk sufficiently to enable insurers to cover everyone, even those with pre-existing conditions. With the mandate in place, we gain an important mechanism for increasing coverage and improving health. We also gain an important lever for controlling costs: when everyone has coverage, you minimize the hidden tax we all pay when providers shift the cost of uncompensated care to those with insurance. Thus, the decision on the mandate is a boon for every Coloradan.
The Court’s action also provides greater certainty to important initiatives. For example, the Colorado Health Benefit Exchange can continue developing a robust marketplace for insurance purchasing for individuals and small businesses in the certainty that the subsidies that will facilitate participation by lower-income individuals will be available. In addition, our expansions of Medicaid eligibility to more low-income people—though not entirely dependent upon the ACA, because many of them were enacted prior to the law—have greater certainty as a result of the Court’s decision.
Yet, there is no room to become complacent. The need to improve health, improve care and control costs remains. Colorado started down the path to reform five years ago, with the work of the Blue Ribbon Commission for Health Care Reform. CIVHC’s work is an outgrowth of that effort. Since then, health reform has remained alive and well in Colorado, as our private insurers, our Medicaid program, our providers, patients, purchasers and policy-makers have all moved down the path the Commission laid out. Now, the Court’s decision provides additional impetus and support for CIVHC’s leadership role in convening engaging and supporting stakeholders in the essential work to improve quality and control costs in Colorado.