The Supreme Court Speaks, Health Reform Continues

My editorial on the health reform law has been posted as part of the new issue of Health Insights Today, here. There’s a focus on the potential effects of the law for chiropractic and CAM, along with broader societal effects that will come with implementation (or repeal).

I hope you all click through to the full editorial. Here’s an excerpt.

First, the landmark provider nondiscrimination rule, Section 2706:

Since most readers of Health Insights Today have a strong interest in chiropractic and complementary and alternative medicine (CAM), let’s begin with the provisions directly related to those fields. First and foremost, the Affordable Care Act’s Section 2706 enacts for the first time a nationwide provider nondiscrimination policy, prohibiting insurance companies from denying coverage based on provider type for services provided by licensed health care practitioners. For example, this policy appears to indicate that if spinal manipulation or acupuncture (or any other service within a practitioner’s scope of practice) is covered when performed by a medical or osteopathic physician, insurers cannot have a policy denying such coverage when the service is performed by a chiropractor or acupuncturist. In the past, such discriminatory policies have had the effect of routing patients away from DCs, LAcs and other non-MD/DO practitioners.

The nondiscrimination rule is a landmark step forward and marks the first time that legislation applies such a policy across the entire nation. However, it does not bar all forms of discrimination. Importantly, insurers are not barred from paying some types of practitioners more than others for the same services. Chiropractors and a variety of other non-MD/DO practitioners sought such a ban but did not achieve it in this legislation. Success on that front will have to wait until later.

The full ramifications of Section 2706 will become clearer over time, as uncertainties are resolved through state and/or federal regulatory actions or litigation. For now, it is seen by chiropractic and CAM leaders and attorneys as the most significant piece of federal legislation in many years. The American Medical Association House of Delegates approved a resolution at its June 2012 national meeting that calls for the repeal of the nondiscrimination policy. While vigilance on the part of chiropractic and CAM organizations remains necessary, this AMA repeal effort faces a steep uphill climb unless the November 2012 election brings a president, House, and Senate that repeals the entire Affordable Care Act. Senate Republican Leader Mitch McConnell and House Speaker John Boehner have pledged to seek full repeal in early 2013. 

I ask each of our readers … please familiarize yourself with what is in the law, so that you will be able to evaluate all claims — pro or con — based on facts rather than distortions.