Dr. Hoff Discusses Supreme Court Ruling on The Affordable Care Act


Timothy Hoff, associate professor of health policy and management, was interviewed recently on WAMC’s The Health Show discussing the Supreme Court ruling on the Affordable Care Act and what it means for the county’s health care system. 

Beginning in 2013-2014, the insurance exchanges and mandates will be the focus of compliance with the act.  Earlier items, such as elimination of pre-existing conditions, requirement for free preventive screenings, elimination of lifetime caps on insurance and the provision to keep children up to age 26 on a parent’s health insurance, were enacted to develop popular support for the law.   Going forward, states that have held off implementing a health insurance exchange, the core of the mandate, will need to move forward with developing exchanges or risk the federal government stepping in.   The mandate for all to have health insurance goes into play in 2014, but there is concern that penalties may not large enough to deter people from not buying health insurance. 

With respect to the expansion of Medicaid, Hoff indicated it remains to be seen how it affects the healthcare system.  Under the Act, a smaller percentage of federal Medicaid funding to the states will be at risk.  For states where Medicaid expansion will help significantly to reduce the number of uninsured, it will be a larger concern.

With an infusion of people with health insurance into the system, access will become front and center “the big issue.”  Hoff suggested looking toward the early experience with health reform in Massachusetts as an example where the existing service delivery infrastructure, particularly in primary care, grew strained.  He points out the delivery structure is not in place nationally, particularly in rural area and inner city areas where more newly insured people will seek care.  Hoff suggests the federal government and private sector will need to become directly involved to improve access and be innovative in the approaches used.

Click here to listen to the interview.