The Supreme Court and the Affordable Care Act: Milestone or Detour on the Road to Universal Coverage?
Authors: Robert B. Doherty
Journal: Annals of Internal Medicine (2012)

Ideas and Opinions16 October 2012The Supreme Court and the Affordable Care Act: Milestone or Detour on the Road to Universal Coverage?Robert B. Doherty, BARobert B. Doherty, BAFrom the American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-7-201210020-00509 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Supreme Court's decision to uphold the Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) may correctly be viewed as a milestone on the path to universal coverage, especially considering the 32 million uninsured persons who would have lost the opportunity to obtain coverage if the court had overturned the entire law. Yet, the Court's surprising decision to allow states to opt out of expanding Medicaid could result in coverage looking a bit like Swiss cheese, with big gaps for the most vulnerable, rather than the seamless expansion of coverage originally expected.Guaranteed Coverage for All Except ...References1. Denniston L. Don't call it a mandate, it's a tax. Bloomberg Law. SCOTUSBlog. 28 June 2012. Accessed at www.scotusblog.com/2012/06/dont-call-it-a-mandate-its-a-tax/ on 28 June 2012. Google Scholar2. Harvey H, Hearne J, Anders S. Updated estimates for the insurance coverage provisions of the Affordable Care Act. Washington, DC: Congressional Budget Office; 2012. Accessed at http://cbo.gov/sites/default/files/cbofiles/attachments/03-13-Coverage%20Estimates.pdf on 5 July 2012. Google Scholar3. Pear R. Uncertainty over states and Medicaid expansion. The New York Times. 28 June 2012. Accessed at www.nytimes.com/2012/06/29/us/uncertainty-over-whether-states-will-choose-to-expand-medicaid.html on 5 July 2012. Google Scholar4. Rosenbaum S. The Supreme Court's Medicaid ruling: “A shift in kind, not merely degree.” HealthAffairs Blog. 28 June 2012. Accessed at http://healthaffairs.org/blog/2012/06/28/the-supreme-courts-medicaid-ruling-a-shift-in-kind-not-merely-degree/ on 5 July 2012. Google Scholar5. Bronson DL. Every American will benefit from Supreme Court's decision to uphold the health reform law. Washington, DC: American Coll Physicians; 28 June 2012. Accessed at www.acponline.org/pressroom/supreme_court_upholds_aca.htm on 28 June 2012. Google Scholar6. Berwick DM. Putting health care on the right track. The Washington Post. 21 June 2012. Accessed at www.washingtonpost.com/opinions/putting-health-care-on-the-right-track/2012/06/21/gJQAtBGltV_story.html on 3 July 2012. Google Scholar7. Iglehart JK. Primary care update—light at the end of the tunnel? N Engl J Med. 2012;366:2144-6. [PMID: 22621420] CrossrefMedlineGoogle Scholar8. Ness D, Weinberger S. Comprehensive primary care initiative: barely a ripple now, enormous promise for later. HealthAffairs Blog. 21 June 2012. Accessed at http://healthaffairs.org/blog/2012/06/21/comprehensive-primary-care-initiative-barely-a-ripple-now-enormous-promise-for-later/ on 21 June 2012. Google Scholar9. Berwick DM. Making good on ACOs' promise—the final rule for the Medicare shared savings program. N Engl J Med. 2011;365:1753-6. [PMID: 22013899] CrossrefMedlineGoogle Scholar10. Clement S. Six charts to explain health care polling. THE FIX by Chris Cillizza. Washington: The Washington Post Co; 28 June 2012. Accessed at www.washingtonpost.com/blogs/the-fix/post/six-charts-to-explain-health-care-polling/2012/06/28/gJQAlBrn8V_blog.html on 5 July 2012. Google Scholar11. Gawande A. Something wicked this way comes. The New Yorker Daily Comment [blog]. 28 June 2012. Accessed at www.newyorker.com/online/blogs/comment/2012/06/something-wicked-this-way-comes.html on 28 June 2012. Google Scholar Author, Article, and Disclosure InformationAffiliations: From the American College of Physicians, Philadelphia, Pennsylvania.Acknowledgment: The author thanks Anna Stoto for her help in editing and checking references.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1687.Corresponding Author: Robert B. Doherty, BA, American College of Physicians, 25 Massachusetts Avenue NW, Washington, DC 20001-7401.Author Contributions: Conception and design: R.B. Doherty.Analysis and interpretation of the data: R.B. Doherty.Drafting of the article: R.B. Doherty.Critical revision of the article for important intellectual content: R.B. Doherty.Final approval of the article: R.B. Doherty.Administrative, technical, or logistic support: R.B. Doherty.Collection and assembly of data: R.B. Doherty.This article was published at www.annals.org on 10 July 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Supreme Court and the Affordable Care Act Stephen Vaccarezza The Supreme Court and the Affordable Care Act Robert B. Doherty Metrics Cited byThe Supreme Court and the Affordable Care ActStephen Vaccarezza, MD 16 October 2012Volume 157, Issue 8Page: 577-579KeywordsForecastingHealth careHealth care qualityHealth insuranceMedicareRunningTaxes ePublished: 16 October 2012 Issue Published: 16 October 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...