Medicare beneficiaries, providers, and plans could face severe harm if the federal courts allow a district court decision striking down the Affordable Care Act (ACA) to stand. As we noted earlier today, a federal court of appeals will hear oral arguments tomorrow on whether to uphold the decision.
The ACA affected many aspects of Medicare, and invalidating the entire law would call all of them into question. In particular, the ACA altered Medicare’s annual payment updates to hospitals, skilled nursing facilities, and certain other health care providers, as well as payments to Medicare Advantage health plans. If the district court’s decision stands, it’s unclear whether the Centers for Medicare & Medicaid Services could continue paying providers and plans or would first have to establish new regulations resetting all of these payment rates.
Beyond the immediate uncertainty and confusion, letting the decision stand could jeopardize the ACA’s Medicare improvements, including:
If the ACA were struck down, the courts might give the President and Congress time to enact a new law to take its place. But in the current political environment, an agreement between the House, Senate, and President could prove difficult to achieve. At the very least, Medicare beneficiaries, providers, and plans would face heightened uncertainty, and at least some of the ACA’s Medicare improvements would likely be lost.