The U.S. Supreme Court ruled on the constitutionality of provisions of the Affordable Care Act (ACA) on June 28. Several experts from the professional schools at the University of Maryland, Baltimore responded with their thoughts on the ruling. The opinions below are only those of the faculty members quoted and not of the University or their respective Schools:
Ellen Weber, JD, University of Maryland Francis King Carey School of Law and creator of its Drug Policy Clinic -
"This is a tremendous victory, particularly in Maryland. The state's efforts to establish the Health Benefit Exchange will all go forward. The state is also prepared to file its application to the Department of Health and Human Services for a second round of federal funds to establish the IT system needed for the Exchange and a number of other tools to put the Exchange in place. That application will be filed by the end of this month, as we understand it, and will be funded. The one limitation that has been reported regarding the Medicaid program - that states that refuse to adopt the expansion for persons up to 138 percent of the federal poverty limit (FPL) will not be penalized with the withdrawal of all existing Medicaid funds - will not affect Maryland. Maryland will move forward with its Medicaid expansion to ensure that all individuals up to 138 percent of FPL will gain coverage to an expansive set of health benefits currently provided to Medicaid enrollees. The State has estimated that an additional 219,000 individuals will be eligible for Medicaid. An estimated 405,000 individuals are anticipated to purchase insurance through the Exchange."
Richard J. Manski, DDS, MBA, PhD, University of Maryland School of Dentistry and a member of the Dental Economics Advisory Group -
"Today's decision is not the beginning and is not the end for health reform in the United States. It is but one more step in a very long process. While the mandate has been sustained in the form of a tax, the decision to expand Medicaid coverage will now be up to the states. Given that public support for the ACA has been tepid at best, it is now for the states to continue the path to reform and then after the November election for the administration and Congress to work with states to put forth a stable, legal, and lasting resolution."
Magaly Rodriguez de Bittner, PharmD, BCPS, CDE,FAPhA, University of Maryland School of Pharmacy and chair of the Department of Pharmacy Practice and Science -
"I am pleased with the Supreme Court decision. The Affordable Care Act has opened the doors for innovation in health care and has advanced many new models of patient-centered, interdisciplinary care that includes pharmacists. Pharmacists have been invited (in many cases for the first time) to sit at the table with government agencies, health care plans and health systems to provide solutions to improve care and decrease overall health care costs. Some provisions in the law represent a formal recognition at the federal level that Medication Therapy Management is a vital component of the nation's health care reform initiatives. It is also a recognition that pharmacists as health professionals are uniquely qualified to deliver these services as members of the health care team."
Robert Percival, JD, MA - University of Maryland Carey School of Law and director of its Environmental Law Program -
"This shows that law has triumphed over politics and that we still enjoy an independent judiciary."
Jane Kapustin, PhD, RN, CRNP, FAANP, University of Maryland School of Nursing and an assistant dean -
"The Supreme Court's decision to uphold the ACA will keep our country on the right path to providing health care for all. As we know, Maryland is farther ahead than most states with setting up insurance exchanges and the technological infrastructure necessary. Today's decision will solidify the wonderful provisions that the ACA mandates such as removing pre-existing conditions and extending insurance coverage for dependents. As a nurse practitioner on the front lines of health care and who is actively involved with health care reform in Maryland, I am thrilled that our uninsured will benefit under the ACA provisions and this is the right step to eliminating health care disparities."
Mark Graber, JD, PhD, MA, University of Maryland Carey School of Law and assistant dean and professor of law and government -
"A partial triumph for the Virginia Plan commitment to a federal government that had the powers to revolve all matters of national interest on which the individual states are incompetent. The United States, if barely, has a government with powers adequate the 21st century."
Bruce Stuart, PhD, University of Maryland School of Pharmacy and executive director of the Peter Lamy Center on Drug Therapy and Aging -
"The Supreme Court opinion upholding the Affordable Care Act is a milestone in our nation's effort to assure that every American has the opportunity to purchase affordable health insurance coverage. Although attention has focused on the individual mandate, other important provisions of the ACA were also upheld. For Medicare beneficiaries a key provision of the law is the gradually filling of the Part D doughnut hole. Beginning in 2011, high drug spenders received 50 percent off brand name medications in the doughnut hole. Given the Supreme Court action today, that discount will now grow to 75 percent for both brands and generics in 2020, providing an important protection for elderly and disabled Medicare beneficiaries who rely on expensive medications to maintain their health."