Like most people, healthcare consultant Paul Keckley, doesn’t believe the recently passed Senate budget resolution spells the end of the Affordable Care Act. Though he’s not so sure when it comes to change to the so-called “employer mandate.”
“There’s a rigorous debate on what is full-time,” said Keckley, managing director for Navigant Center Healthcare Research and Policy Analysis. “It will be tweaked but it doesn’t go away.”
[Also: Senate budget targets Obamacare]
What’s more significant to the future of the employer mandate and the ACA in general is the upcoming Supreme Court decision in King v. Burwell, which everyone is watching.
The ruling will decide whether millions of Americans who gained healthcare coverage in 34 states that use the federal exchange, will lose their subsidies.
[Also: Insured wait on King v. Burwell decision]
The plaintiffs argued the ACA allows subsidies to be given only in those states that established their own marketplaces.
Keckley said the odds-on favorite is for a 6-3 decision by the Justices in favor of Health and Human Services Secretary Sylvia Burwell, upholding the current law.
But it’s not a sure bet.
“I think if King v. Burwell plays out for the plaintiffs, the employer mandate goes away,” Keckley said. “My sense is they’ll uphold (the current ACA).”
If Republicans don’t achieve their aim of dismantling the law, the budget resolution does have the power, or should, of forcing the Centers for Medicare and Medicaid, and other delivery systems to demonstrate how ACA-initiated programs for shared savings have actually saved money, Keckley said.
[Also: King v. Burwell arguments held in U.S. Supreme Court]
Accountable care organization models have been touted as raising the quality of healthcare while reducing cost. But Keckley doesn’t believe the savings have lived up to the hype.
“So far, the impact of the ACA on savings is not substantial,” he said. Of 424 Medicare Shared Savings Programs participants, the savings is a modest half billion, he said.
“As I read this thing,” Keckley said of the budget resolution, “doesn’t this put pressure on CMS to say, ‘We’ve got cost-saving measure in the law?’”
If the goal of the Senate is to reduce spending by a trillion, he said, this is the time for the administration to say it can get there.
“I think this sets up a discussion,” he said. “It obviously puts the ACA into Campaign 2016, Page One.”
Twitter: @SusanMorseHFN