Health

Large GPOs involved in Obamacare decision push to close health coverage gaps

Industry leaders say the U.S. Supreme Court’s decision last week to defend the Affordable Care Act could make it more difficult for future lawsuits to challenge the law. The ruling also frees up New York state to seek to provide coverage to those who are still uninsured.

“Since the passage of the ACA, New York has done more in the last decade than almost any other state to expand health coverage, strengthen services for its most vulnerable residents, and improve the quality of care,” he said. said Eric Linzer, president and CEO of the New York Health Plan Association, which represents 28 members. The court’s decision “will ensure that the coverage of millions of New Yorkers depends on being protected.”

New York leaders have played a role in the court’s decision, said Kenneth Raske, president of the New York Hospital Association. GNUHA has teamed up with other hospital associations to present a brief amicus in defense of the law, led by Attorney General Letitia James and other state attorneys general, Raske said.

“We strongly support the ACA, which has made health care accessible to so many Americans, and we are grateful that it has survived once again the legal challenge,” Raske adds.

The ACA has resisted two previous legal challenges in the Supreme Court.

“We hope this case stops once and for all because of these causes, which unnecessarily jeopardize health insurance coverage for millions of patients in New York and across the country,” said Dr. Joseph Sellers, president of the Society. New York State Medical.

A court victory might not necessarily explain the end of challenges by Republicans, but it will make it more difficult for future attempts, said Diana Silver, associate professor of public health policy and management at New York University School. of Global Public Health.

“This eliminated another way for opponents to get in,” Silver said. Supporters have been on the trail since the Supreme Court announced it would take the case, and odds appear to have piled up in favor of opponents, he added.

Thursday’s decision frees up time and energy for New York and other states to focus on extending coverage to those who are not yet insured, he said.

With more than 95% of residents insured, the focus now should be on the goal of universal health care, Linzer said.

Although the ACA did not greatly extend the state’s Medicaid benefits, since they were already broad, it ensured full coverage – eliminating exclusions for pre-existing conditions and payment limits and also establishing preventive care – for the New Yorkers, Silver said.

The court’s decision also ensures that state accounts care organizations – groups of providers working to improve health outcomes by reducing costs – can continue to thrive, he said.

“The ACA had allowed for a change of funding for the ACO that would focus not only on providing services, but also on results,” he said.

As of January, there were about 477 national ACOs, of which about 30 were in New York.

“Those entities would not be able to function if ACA was hit,” Silver said.

This story first appeared in our sister publication, Crain’s New York Business.


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