August 2, 2021
We are thrilled to welcome Casey Korba to the Policy Team. Casey was previously at the Deloitte
Health Policy Center and is joining the team as the Director of Policy. When you hear from Casey
for the first time, please join us in welcoming her to the team.
Affordable Care Act again upheld by the Supreme Court
With ACA back in the Supreme Court, we are lucky to have Ilona Cohen, Aledade’s Chief Legal
Officer, share her expertise on what this latest ruling means for the ACA going forward.
Last week, in a highly anticipated opinion, the Supreme Court firmly rejected the latest
challenge to the Affordable Care Act (ACA). The case California v. Texas arose after
Congress amended the Act’s provision known as the “individual mandate” to eliminate
the financial penalty imposed on individuals who fail to maintain a minimum level of
health insurance. Texas, along with some other states and two individuals, claimed that
the decision to eliminate the penalty rendered the ACA’s individual mandate provision
unconstitutional and, because the Supreme Court previously had held in an earlier
opinion that the financial penalty imposed by the individual mandate had made the law
constitutional, they argued the whole ACA needed to be struck down.
The Court, in a 7-2 ruling, found that the case should be dismissed because none of the
plaintiffs had been harmed by Congress’ decision to remove the financial penalty within
the mandate. Because the plaintiffs had not suffered any injury, they had no “standing” to
challenge the mandate and the court refused to hear the merits of the plaintiffs’
arguments. While this particular challenge to the ACA died with a whimper on the
standing issue, it may not be the last such challenge. That said, the majority of legal
scholars seem to think that further challenges to the ACA are either unlikely or will not
succeed. This decision, therefore, which affirms for the third time that the ACA is
constitutional, is good news for everyone who relies on the patient protections, market
reforms, and value initiatives in the Act.
More Leadership at CMS
Jonathan Blum has started as Principal Deputy Administrator (essentially the number 2 person)
at CMS. Jon Blum previously worked at CMS and has a variety of experience working within the
healthcare landscape, namely at CareFirst (Maryland Blue Cross Blue Shield). He is very familiar
with value programs and is a good ally to have at CMS. We expect the Center for Medicare and
the Center for Medicaid to have Directors very soon. While the 2022 Physician Fee Schedule is far along in its proposal, these new leaders will be the audience for any changes we want to make in the final regulation.