Q&A: We now have a framework for health reform

Much of the coverage and ensuing political wrangling about the June 28 Supreme Court ruling on the Affordable Care Act will be on the nitty-gritty of how the justices arrived at their decision to uphold as constitutional the ACA, including the contentious individual mandate and most of the Medicaid expansion provisions. Indeed, that’s paramount but perhaps not as important as how the law will ultimately play out. And that is inevitably going to be different in various parts of America.

Government Health IT Editor Tom Sullivan spoke with Bill Bernstein, chairman of the healthcare division at law firm Manatt, Phelps & Phillips, which works with states and providers on health IT and related public policy issues, about those issues as well what the ruling means for Manatt’s clients in terms of moving forward with health IT projects, and the impact it could have on Republican presumptive nominee Mitt Romney, who has been stumping on ACA repeal.

Q: Given the public sentiment here on the health reform law, is the court’s ruling surprising?

A: It’s interesting how they got there. But in the end, what’s going to matter is not their constitutional reasoning but how it plays out. At this point, I think the forum really changes, goes to the states. As the opinion makes clear, I don’t think the justices were looking at public sentiment. Just from reading the opinion, I think they based this on a well thought theory of the powers of federal and state government. I'm reading he Roberts opinion, just halfway through it, and it’s impressive.

Q: Just knowing how the court has ruled will put many people in the healthcare realm at ease…

A: I think so. We all know somebody with a pre-existing condition. A big part of this is the facet that if you apply for coverage you have to receive it and the fact that they can’t discriminate based on pre-existing conditions. That’s a huge step forward in terms or providing people access to basic healthcare coverage – and that’s a big day in American history.

Q: And among Manatt’s clients, do you anticipate a sense of hurry up and wait among healthcare organizations out there? There is still uncertainty with the coming election on the horizon and Mitt Romney threatening to repeal the ACA…