Tim Hoff Interviewed on The Health Show

Timothy Hoff, associate professor of health policy and management, was interviewed recently on Northeast Public Health’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.  Hoff agreed the decision was a surprise to many, having not expected the Commerce Law to be the deciding factor. 

Beginning in 2013-2014, the insurance exchanges and mandates will be the focus of compliance with the act.  Earlier items, such as elimination of bans on 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 steeping in.   The mandate for all to have health insurance goes into play in 2013, but  there is concerned penalties are not large enough to deter people from not buying health insurance.  Hoff pointed out very few people will pay a penalty and those who do will not pay a large penalty, at least early on as the law is not set up with high penalty provision.


With respect to expansion of Medicaid, Hoff indicated it has larger implications for the healthcare system and questions if expansion will hinder the federal government’s “power of purse” to get states to do what they want them to do.  Under the Act law, only about 10% of funding from the federal government to the states will be at risk.  For states where Medicaid expansion will support shift of all to a health plan, it will be a larger concern.


With an infusion of people with health insurance, access will become front and center “the big issue.”  Hoff suggested looking toward the experience in Massachusetts as an example.  He points out the delivery structure is not in place, particularly in rural area and inner city areas where people will be able to go for care.  Hoff suggests the federal government and private sector will need to become involved and be innovative in their approaches.


Click here to listen to the interview.