Texas Court Rules ACA Unconstitutional: January 2019 Healthcare Hot Takes

Legal cases

Healthcare Hot Takes is Luma Health’s monthly rundown of healthcare innovations happening right now. Check out what the industry is thinking, reading, doing. This month’s main topic is the ACA court ruling in Texas.

Story #1: Federal Judge in Texas Rules Affordable Care Act as Unconstitutional

The big news this past month was that a federal judge in Texas struck down the Affordable Care Act, (ACA) more commonly known as Obamacare, on the basis that its individual mandate to purchase health insurance is unconstitutional. The judge has also ruled that without the mandate, the rest of the law has no foundation. For now, as the case continues to make its way through the courts, the ACA remains the law of the land.

The original lawsuit was filed by a group of Republican state administrations and consequently, a group of Democratic state administrations has promised to appeal the decision. Eventually, it’s likely the case lands in the Supreme Court. If ruled unconstitutional by the Supreme Court, then health coverage for millions, guaranteed coverage for pre-existing conditions, and countless other measures enacted by the ACA would be at risk.  

Due to President Trump’s tax overhaul in December, Congress reduced the tax penalty to zero dollars for those people who don’t have health insurance. In 2012, the Supreme Court’s decision to uphold Obamacare as constitutional was based solely on Congress’ ability to impose that tax penalty. Without it, the individual mandate’s constitutionality is now back in question.

Luma’s Hot Take: The Supreme Court’s decision on the individual mandate’s constitutionality will have immense ramifications for the entire healthcare industry. If Obamacare is struck down without a suitable alternative in place, millions could be left without health insurance, severely limiting access to care and, ultimately, leading to poorer health outcomes for the uninsured.

Watch our on-demand webinar to learn more about how to leverage reimbursable HIPAA-compliant virtual visits to deliver care and minimize appointment backlogs and cancellations.

Story #2: Hospital Beds are Getting Digitized in Order to Monitor Vital Signs of Patients

Hill-Rom Holdings, one of the leading global manufacturers of hospital beds, is releasing a new model with capabilities to detect patients’ heart and respiratory rates. The beds will have multiple sensors that check a patient’s vital signs 100 times a minute, alerting the nurse or care team when a patient’s condition worsens.

Most other bed manufacturers don’t have this capability, but a few companies including Linet and Stryker are exploring movement sensors that can detect when patients are at the risk of falling.

This is yet another example of hospitals increasingly digitizing in the modern age, with medical equipment suppliers taking notice and cashing in on the trend.

Luma’s Hot Take: Hospitals are truly investing in digital health and are committing to better monitoring patients in real-time. By transforming a simple mainstay such as the hospital bed into a vital sign monitor, facilities are embracing technology and data to improve systemwide care and reduce costs in the long-term.

With more and more hospitals closing, it is important to figure out how to improve patient access in those areas.

Story #3: Patient Access to Hospitals is Directly Correlated to Their Community Type

A Pew Research center survey conducted earlier this year suggests that rural Americans are much more likely to struggle with limited access to suitable doctors and hospitals than those living in urban and suburban communities.

One major factor that contributes to this is the distance needed to travel to the nearest hospital or medical facility. People in rural areas have much longer travel times and fewer reliable transportation methods to their nearest point of care. For example, the average travel time to the nearest hospital for people living in rural communities is 17 minutes. Compare this to 12 minutes for those living in the suburbs and 10 minutes for those living in urban areas.

Studies like this are important to determine the level of patient access in certain communities throughout the country. Recently, rural hospitals have been closing at an alarming rate (64 hospitals closed from 2013 to 2017) leaving more and more patients without access to care.

Luma’s Hot Take: With more and more hospitals closing in rural communities, it will be important to figure out how to improve patient access in those areas. While some basic care can be provided at one-stop shops (see CVS Minute Clinics) and by virtual means like telehealth, more complex care will need to be provided at appropriate medical facilities like hospitals and urgent care centers.

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