John Gorman's take-aways from the Supreme Court decision:
- This was DC's best kept secret since JFK and Marilyn Monroe. It's hard to believe it was kept a secret for as long as it was.
- By calling it a tax, Justice Roberts finessed the interstate commerce issue, avoiding a new precedent. The SCOTUS really threaded the needle here.
- This is a monumental victory for Congressional Democrats and the President.
- Most of the 26 Red states that filed the lawsuit, and others that have taken a "wait and see" posture to the ACA, are now way behind on implementation when it comes to the Federal exchange.
- The ruling means that there's zero impact on Medicare. It's like the case never happened. This removes a lot of uncertainty for the industry.
- The cuts to Medicare Advantage and the Stars Bonuses stay.
- Dual Eligibles move forward under state initiatives into health plans.
- ACOs move forward. The jelly stays in the doughnut hole on Part D.
- The minimum MLR rule in Medicare Advantage takes effect in 2014.
- The RDS subsidies phase out - meaning employers will really start to shift their retirees to plans in 2014, 2015, and 2016, which will fuel MA enrollment.
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The GHG Blog:
Nathan Goldstein blogs on the Supreme Court decision:
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... the significance of Chief Justice Roberts' vote is that it expands the Government's power, in functional terms, to tax. That's pretty darn important. However....
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