Court upholds subsidies in ACA
Health care organizations and millions of people across the country can breathe a sigh of relief. The Supreme Court has upheld the subsidies established by the Affordable Care Act that help about 6.4 million Americans purchase health insurance on the federal exchange. Had the court struck down those subsidies, more than one million Texans might have lost their coverage.
President Obama addressed the nation from the White House shortly after the ruling was announced, saying there could be no doubt that the ACA is working and that the law is here to stay.
“Today is a victory for hardworking Americans all across this country whose lives will continue to become more secure in a changing economy because of this law,” the president said.more
Report from TACHC, TAFP says Supreme Court ruling could worsen growing consequences to Texas’ refusal to expand Medicaid coverage
More than 1 million Texans might lose their health insurance if the Supreme Court rules against the Obama administration this month in King v. Burwell. Such a ruling would deny premium subsidies to Texans and residents of 35 other states that refused to establish state exchanges under the Affordable Care Act.
Texas’ decision not to expand Medicaid coverage under the Affordable Care Act already leaves more than a million low-income, uninsured Texans without access to Medicaid or to federal subsidies to help them purchase insurance. A new report, “How will Texas’ Affordable Care Act Implementation Decisions Affect the Population? A Closer Look,” written by health care law and policy experts at George Washington University and commissioned by the Texas Association of Community Health Centers and TAFP examines the effects of that decision and the compounded damage to the state’s economy and health care infrastructure that would accompany a Supreme Court ruling in favor of the plaintiff.
“The combined effects of not expanding Medicaid and the potential impact of King v. Burwell will hit Texas’ health care system hard,” according to the report. “County‐level estimates show that prior to implementation of the ACA, 38 counties experienced hospital annual uncompensated care levels of $50 million or greater, and four counties showed losses greater than $200 million. Texas’ failure to adopt the Medicaid expansion, coupled with the loss of premium subsidies as a result of a decision against the government in King would reverse the progress that has been made in reducing the number of uninsured Texans. Furthermore, hospitals could find that the demand for charity care actually rises, as thousands of previously‐insured people with serious health conditions turn to their hospitals for help.”more
Cutting out the middle man
By Dale Ragle, MD
TAFP President, 2014-2015
Greetings colleagues. Do you remember a time when you could take care of your patients without any of the hassle and expense associated with billing insurance companies? When you could spend as much time with your patient as needed? When you simply received payment from your patients instead of some third-party payer?
Many physicians practicing today have only heard stories of those days, but a growing number are rediscovering them by stepping off the insurance treadmill and contracting directly with their patients. Direct primary care is an innovative model for delivering and purchasing health care services that gives physicians and their patients an alternative to the third party, fee-for-service system. For a flat monthly fee, patients have unlimited access to their doctor—in person and by phone or e-mail—for a full range of comprehensive primary care services including acute and urgent care, regular checkups, preventive care, chronic disease management, and care coordination.more
A new way to train family physicians
By Richard Young, MD
What is the best way to train comprehensive full-service family physicians to learn how to thrive in underserved rural Texas? How have duty hour restrictions affected residents’ training with this goal in mind? JPS might have some answers.
The John Peter Smith Hospital Family Medicine Residency Program was chosen to be one of 14 programs to participate in the Preparing the Personal Physician Practice (P4) experiment, which was conducted from 2007 to 2012. The leading organizations that regulate family medicine residencies allowed JPS and 13 other programs across the U.S. to blow up their curricula and start all over. JPS innovated its curriculum in two primary ways. This is a report on some of our preliminary results.more
Missed opportunities in the 84th Texas Legislature
By Tom Banning
Yogi Berra famously said I hate making predictions, especially about the future. It’s particularly painful when those predictions come true as was the case for many of the predictions TAFP made at the outset of the 84th Texas Legislature on how health care issues would fare this session.
Playing to their primary voters, the House and Senate focused attention almost solely on tax cuts, border security, transportation, when and where you can carry a gun, and a host of other mostly inconsequential partisan ideas.more