Perhaps consultant Bob Laszewski, president of Health Policy and Strategy Associates, LLC and a former health insurance executive, said it best after the Supreme Court ruled June 28 to uphold almost all of the health reform law. Laszewski's reaction was: "In the immortal words of Roseanne Rosanna Danna [on old Saturday Night Live shows on television], 'Never mind.'" In other words, the basic impact of the court's long review of the law, at least as it pertains to Medicare Advantage and Part D plans, is that the law continues to be in full effect, and insurers and their partners need to keep implementing the provisions because it's "back to the future."
It could have been a lot different. Had the court struck down the entire law, notes Bruce Merlin Fried, a partner in the SNR Denton LLC law firm and a former health plan czar at HCFA (before it became CMS), it would have been "something approaching chaos" for the MA industry. For one thing, the new payment methodology that already is largely in effect would have had to revert to the system in effect before the reform law's enactment. While that would have meant elimination of some payment cuts, it also could have meant the end of CMS's stars quality-bonus program and probably a huge cutback in the contemplated new initiatives for Medicare-Medicaid dual eligibles. The old open-enrollment periods might have come back just after MA plans were finally starting to get used to the new schedules.
But this doesn't matter anymore because that's not happening — at least for now. MA plans can perhaps heave a sigh of relief, but not for long since, as Laszewski said, now it's "on to the elections," and anything can happen then. What do you think is the significance of the Supreme Court ruling for MA? Is it "never mind" or instead "to be continued"?
Laszewski is one of 28 industry experts participating in New Health Insurance Business Models for a Post-Reform World, a two-day conference on Oct. 4-5 in Washington D.C. Visit www.AISHealth.com/roundtable/october2012 to review the Full Program and see the “Who’s Who” of health business leaders you can interact with during seven Health Business Roundtables on compelling bottom-line issues for health care professionals.