Thursday, June 28, 2012

The Supreme Court Decision: Big Answers, but Significant Questions Remain

Today's post is contributed by Heather King, the Medicaid Drug Rebate Program Summit Conference Producer.  MDRP 2012 will take place September 10-12, 2012 in Chicago, IL.

The Supreme Court Decision: Big Answers, but Significant Questions Remain

Let’s face it. We’re all kind of surprised by a few things that we found out this morning.
  1. 1) The PPACA was pretty much upheld in its entirety, including the very controversial individual mandate.
  2. 2) The swing vote was Chief Justice John Roberts, and not Anthony Kennedy.
  3. 3) CNN really screwed up its reporting of the decision.
I’ll let #3 speak for itself because honestly, what else is there to say when a major news organization is so monumentally wrong on our President’s defining piece of legislation?

I also won’t expound on #2 except to say that I’m honestly in shock.

So let’s focus on #1, which is really what’s important. This is arguably the most important SCOTUS decision since Bush v. Gore because it decided the direction of the country for the following four years. This decision, affects everyone in the country, from birth to death. That’s a lot longer than four years. While those on the left are whooping it up and patting each other on the back, the reality is that there is still the looming specter of its demise, if the Republican candidate, Mitt Romney, is elected President. He has promised to undo PPACA.

But that possible reality is still many months away and so for now, it signals many things, including the continuing expansion of Medicaid, which will directly affect the Medicaid Drug Rebate Program and other government reimbursement programs, like the 340B program. There are questions though. The only part of the law that was restricted, was seems to be this expansion. SCOTUS’ opinion says, “the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion.” This decision gives states some flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for. What is uncertain, is which states will choose to expand Medicaid and which won’t, meaning how many Americans will be added to the Medicaid program, and how much more rebating will branded and generic manufacturers have to do? As more experts weigh in, we’ll dissect this a bit more.

But for now, at least the decision has been made and we can all exhale. The changes the pharmaceutical and healthcare industries have already made to implement PPACA are not for naught….until possibly November.

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