Most prognosticators seem to think that at least part of the Affordable Care Act will be struck down by the Supreme Court. Maybe I'm too much the optimist, but I think there's a reasonable chance that Justice Anthony Kennedy will respect a century of precedent on the commerce clause. But, I'm no lawyer.
In any case, Eugene's Register-Guard does an admirable job of summing up the impact on Oregon's efforts to transform health care delivery should the Supremes kill the ACA. In short - we might lose some critical funding (especially if the whole law is struck down), but the central reform will stay in place.
Oregon already has trimmed more than $12 billion in Medicaid costs over the last 15 years through efficient management and prioritization of services. Under the state’s health care transformation, the state is working with local communities to establish coordinated care organizations, or CCOs, that will work to reduce expensive hospital stays and emergency room visits by focusing on preventive care, disease management and early intervention. The state expects the CCOs to save $11 billion over the next decade. Even larger savings could be achieved if the concept is extended to populations beyond those eligible for Medicaid.
The interest of federal officials in Oregon’s bold experiment is understandable. If it works as planned and is replicated in other states throughout the nation, the 10-year savings could exceed $1.5 trillion. Uncontrolled health spending is the U.S. health care system’s primary problem, and Oregon’s overhaul of its Medicaid health care delivery model, with its sharp focus on effective outcomes rather than the amount of services rendered, could provide a national model of how to provide quality health care at an affordable price. ...
If the Supreme Court, as many believe it will, throws out all or a major portion of the federal health care law, Oregon’s health care transformation experiment will draw even more intense scrutiny than it already is. That’s nothing new for a state with a proud and long-standing tradition of innovation and national leadership.
The whole thing is worth reading. What do you think? Will the Supremes strike down some or all of the health care reform law?