On Thursday, the U.S. Supreme Court in a 5-4 ruling upheld the major elements of the federal health reform law, the Washington Post reports (Barnes/Aizenman, Washington Post, 6/28).
According to the Wall Street Journal's "CIO Report," the decision could have implications for health IT deployments in the U.S. health care industry (Hickins, "CIO Report," Wall Street Journal, 6/28).
Details of Majority Opinion
Chief Justice John Roberts authored the majority opinion, which garnered the support of the high court's four liberal justices (Haberkorn, Politico, 6/28).
Roberts noted that the reform law's individual mandate -- which requires most U.S. residents to purchase health insurance -- "may reasonably be characterized as a tax" and is therefore constitutional (Stempel/Vicini, Reuters, 6/28).
The majority also affirmed the constitutionality of the Medicaid expansion provision in the law. However, the justices struck down the provision that would have allowed the federal government to withhold existing Medicaid funding if the states failed to comply with the expansion (Washington Post, 6/28).
Details of Dissenting Opinion
In the dissenting opinion, Justices Anthony Kennedy, Antonin Scalia, Clarence Thomas and Samuel Alito said the entire reform law should have been struck down.
Kennedy wrote in the dissent that the law "exceeds federal power both in mandating the purchase of health insurance and in denying nonconsenting states all Medicaid funding" (Sherman, AP/San Francisco Chronicle, 6/28).
Health IT Implications of Ruling
The Supreme Court ruling clears the way for health care providers to continue working on health IT projects related to the implementation of the reform law, according to the Wall Street Journal's "CIO Report" ("CIO Report," Wall Street Journal, 6/28).
Although the reform law does not directly address health IT adoption, some of the law's Medicare programs give preference to health care providers who have installed electronic health record systems (iHealthBeat, 6/22).
Other health IT-related provisions of the reform law include:
- Demonstration projects for accountable care organizations, which use IT tools;
- New collection and reporting responsibilities on health care disparities;
- New health care-associated data collection by the Internal Revenue Service;
- New operating rules to standardize HIPAA transactions;
- Online-based insurance exchanges at the state level; and
- Web-based enrollment for health care and human services programs (iHealthBeat, 2/1/11).
Health IT Stakeholders React to Supreme Court Ruling
In a statement, the eHealth Initiative said, "By upholding the law, the uncertainty about governmental programs to advance greater care coordination in the delivery of health care and quality-based payment reforms, supported by health IT, is removed" (eHealth Initiative release, 6/28).
H. Stephen Lieber -- president and CEO of the Healthcare Information and Management Systems Society -- in a statement said, "Now that the uncertainty around [the health reform law] has been settled, it is critical that we continue the momentum to transform health care, including the use of information technology." He added, "We are pleased that congressional support for nationwide adoption of health IT on both sides of the aisle remains strong, and has been unaffected by the debate on the health care reform law" (HIMSS release, 6/28).
Ruling Does Not Affect Meaningful Use Program
The Supreme Court ruling does not affect the meaningful use program, which was created by the 2009 federal economic stimulus package, not the 2010 health reform law. Under the stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments (iHealthBeat, 6/22).
In a statement, HIMSS said, "[W]hile there are many potential implications for health IT in the [health reform law], the Medicare and Medicaid [EHR] Incentive Program was never in jeopardy regardless of the outcome of this case" (HIMSS release, 6/28).