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What Happened on June 28, 2012

July 24, 2012
by Mark Hagland
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Healthcare IT leaders continue to move forward to lay the IT foundations for the new healthcare—just at they were before the Supreme Court's ACA decision

The early morning hours (local time) of Thursday, June 28 reminded me once again of a few of the many reasons why I love being a journalist. On that morning, shortly after 10 a.m. Eastern time, the Supreme Court handed down its much-anticipated ruling in National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al.—the ruling on the constitutionality of the Affordable Care Act (ACA), President Barack Obama’s signature domestic legislation, and the focus of debate and the subject of several lawsuits that ultimately coalesced into National Federation.

I was actually in Ojai, Calif., attending and covering the annual physician symposium of AMDIS, the national association of CMIOs. The day before, I had been listening to presenters speak on a variety of topics, all of them related to the very affirmative push forward on the part of CMIOs and their colleagues nationwide towards helping to create the healthcare system of the future that will be more transparent, accountable, cost-effective, and of higher patient care quality and patient safety—that everyone agrees we need.

During the sessions on Wednesday, June 27, numerous brief allusions had been made to the Supreme Court case, with everyone in the ballroom at the Ojai Valley Inn and Spa being highly aware that whichever way the nation’s highest court ruled could have a profound impact on healthcare policy. Yet it was equally clear that what has been called “internal” healthcare reform would go forward whatever the Supreme Court decided.

In the end, as everyone now knows, in a 5-4 ruling led by Chief Justice John Roberts, the Supreme Court affirmed the constitutionality of the ACA, ruling that, though the law’s individual mandate for health insurance purchase could not be constitutionally justified under the Commerce Clause of the U.S. Constitution, it could be upheld as a de facto tax, though the court did curtail the federal government’s ability to withhold Medicaid funding from states whose governments refused to participate in the law’s Medicaid expansion.

Though 10 a.m. Washington time is only 7 a.m. California time, I had made sure to be set up before 7 a.m., and was in place at my laptop as the ruling was handed down and made public. Watching journalists reading live from the decision, I was also, like more than 800,000 people, following postings on, the premier source of information on the Supreme Court, moment by moment.

Quickly batting out a first news story within minutes, I worked with everyone on our editorial team at Healthcare Informatics to produce a series of news and reaction stories and get them on our website as soon as possible. It was exciting to cover this extremely significant event live. I’m happy to say we covered it all accurately, and following my first news story posting, I quickly drove to the conference hotel to get reactions from CMIOs (“After Supreme Court ACA Ruling, HIT Leaders Ready to Move Forward,” page 32). What did they tell me? Largely that the internal reform work they were all engaged in would move forward as planned, though now with greater federal policy certainty.

It was exciting to be a journalist on a very big news day like June 28. But it is even more exciting to be given the privilege of reporting long-term on the new healthcare that is emerging, step by step and day to day, thanks to countless dedicated healthcare professionals. And as that process moves forward, I and everyone else on our editorial team are dedicated to bringing you, our readers, the most meaningful and insightful news and commentary possible, to support an unstoppable movement of truly homegrown reform that is building forward every day.

Mark Hagland