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Premier’s Blair Childs: Battle Over Affordable Care Act Far from Over

June 28, 2012
by Gabriel Perna
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Childs applauds Supreme Court’s ruling on ACA

Across the nation, reactions continue to pour in after the U.S. Supreme Court ruled, by a 5-4 margin, to uphold the Affordable Care Act, President Barack Obama’s signature domestic act. Blair Childs, senior vice president of public affairs at the Premier Health Alliance, a profit-based performance improvement alliance of more than 2,600 U.S. hospitals and 84,000-plus other healthcare site, gave his approval over a decision that he says will continue the progress of health reform.

Childs, in an exclusive interview with Healthcare Informatics, said the Supreme Court’s ruling was one of two things he thought would happen. The Court ruled that the individual mandate for the purchase of health insurance was affirmed not under the Commerce Clause of the U.S. Constitution, but in the form of a tax. With regard to the individual mandate, the court ruled that the federal government cannot use the Commerce Clause to justify the individual mandate, as the government cannot force people to purchase services. However, it sustained the mandate under the concept of its being a tax, as there is no criminal or civil penalty for not purchasing health insurance under the ACA.

According to Childs, this was victory for progression. “The controversy around health reform will continue, but this at least keeps in place the reforms, that frankly are bipartisan, that are essential to fix our antiquated Medicare system, these are reforms that increase transparency, patient-centeredness, and better align payment with value,” he said.

Certain aspects of the Affordable Care Act such as value-based purchasing, accountable care organizations (ACOs), bundled payments, the Physician Payments Sunshine Act, are the kinds of things the healthcare system needs, according to Childs.

“They were less controversial [than the individual mandate] but had this bill been struck down,” Childs says, “it would have meant slowed progress. Hospitals and health systems are full speed in Premier, they wouldn’t have let up, it would have definitely slowed progress had the bill struck down.”

Childs says investments into the various health IT systems that are making these reform mandates easier to comply with, would have seen slowed progress in investments. Although, he notes it wouldn’t have been slowed entirely, since the market is moving in this direction anyway.  “Everyone understands that data and the ability to predict illness, track patients and manage patients, requires information data,” he says.

Childs also weighed in on the Supreme Court’s ruling that the Medicaid expansion provided for in the act is constitutional, but that it would be unconstitutional for the federal government to withhold Medicaid funding for non-compliance with the expansion provisions. He said it was kind of “meaningless,” since “no one is going to turn away” those funds.

Meanwhile, Childs does note that the battle over the Affordable Care Act is far from over.  “This removes one of the uncertainties, the politics of healthcare will still continue,” Childs said.

The Premier Alliance did issue an overall statement. “Today’s Supreme Court ruling will have little impact on the Premier healthcare alliance’s work to increase transparency and successfully implement changes that better align payment with quality and value,” Premier president and CEO Susan DeVore, said in the statement.

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"Childs also weighed in on the Supreme Court’s ruling that the Medicaid expansion provided for in the act is constitutional, but that it would be unconstitutional for the federal government to withhold Medicaid funding for non-compliance with the expansion provisions. He said it was kind of “meaningless,” since “no one is going to turn away” those funds."

Has he met Gov. Kasich of Ohio? 1) Kasich will likely do everything he can do to slow the progress. 2) He will probably decline the funds offered to make the implementation of the Insurance Pools easier - he tried to convert high-speed rail funds to highway funds and then later declined them altogether when he learned that conversion wasn't possible. 3) If he can't use the increase in funds to take care of those already enrolled and then use the funds from the state's block grant to handle the increased enrolment, or some such nonsense or get a guarantee that he can decrease the Medicaid enrolment as the federal funding decreases three and four years out, he may refuse the new Medicaid funding.