The Affordable Care Act, frequently referred to as ObamaCare, is pending before the Supreme Court of the United States as to whether the law is constitutional.
The American people are closely divided when asked whether they approve of the law, but when asked about specific provisions of the law, such as the closing of the prescription coverage gap, called the doughnut hole, and no-charge preventive services, such as an annual wellness physical, a large majority supports the separate pieces of the law.
The Obama administration recently issued a warning about the adverse effects on Medicare if the entire law is overturned by the Supreme Court. This warning was detailed in an article recently in the Detroit Free Press. Here are excerpts:
Medicare's payment system, the unseen but vital network that handles 100 million monthly claims, could freeze if President Barack Obama's health care law is summarily overturned, the administration quietly informed the courts.
Although Obama's overhaul made significant cuts to providers and improved prescription and preventive benefits, Medicare was overlooked in Supreme Court arguments that focused on the law's controversial requirement that all individuals carry health insurance.
In papers filed with the Supreme Court, administration lawyers warned of "extraordinary disruption" if Medicare is forced to unwind countless transactions that are based on payment changes required by more than 20 separate sections of the Affordable Care Act.
Opponents say the whole law must go. The administration counters that even if the court strikes down the insurance mandate, it should preserve most of the rest of the legislation. That would leave in place the changes to Medicare and a major expansion of Medicaid coverage.
Last year, in a lower court filing, Justice Department lawyers said reversing Medicare payment changes "would impose staggering administrative burdens" on the government and "could cause major delays and errors" in claims payment.
The AARP says it's concerned. If doctors became embroiled in a legal battle over payments, then "a general concern would be that physicians would cease to take on new Medicare patients, as well as potentially have issues seeing their current patients," said Ariel Gonzalez, an AARP lobbyist.
Medicare payment policies are set through a time-consuming process that begins with legislation passed by Congress. Even if the law were completely overturned, the government would have authority under previous legislation to pay hospitals, doctors, nursing homes and other providers.
It's not just reimbursement levels that would get scrambled, he said. The law's new philosophy of paying hospitals and doctors for quality results, rather than for sheer volume of procedures, has been incorporated into some payment policies.
"There is no doubt that striking down Medicare provisions would be enormously disruptive for patients, physicians, hospitals and countless other providers and suppliers," said Rep. Sander Levin of Royal Oak, ranking Democrat on the House Ways and Means Committee, which oversees the program.