Hospitals, physician practices and health insurers breathed a sigh of relief on Election Night as President Barack Obama’s re-election signaled that his administration’s signature legislation—the health reform law—will remain the law of the land and provide some financial clarity for health care stakeholders.

After the health reform bill was upheld by the Supreme Court in June, hospital CIOs and others expressed relief that, whatever their personal misgivings about more government intervention in the market, health reform would ensure that millions of the uninsured would now be able to pay their medical bills thanks to Medicaid expansion and the individual mandate.

In addition, the Supreme Court’s ruling meant that the EHR meaningful use incentive program, as well other initiatives such as the formation of accountable care organizations, would continue to receive government support.

President Obama’s re-election on Nov. 6 also will likely stop a seemingly election-timed effort by Republican House leaders to halt and “fix” the meaningful use program.

Republican leaders Dave Camp and Wally Herger, chair of the Ways and Means Committee and its health subcommittee, respectively, and Fred Upton and Joe Pitts, chair of the Energy and Commerce Committee and its health subcommittee, had sent a letter in early October to HHS Secretary Kathleen Sebelius, asking her to put the brakes on the program and stating, by their estimates, $10 billion had already been spent with little to show for it.  

With Obama back in the White House and a still-Democratic Senate, those calls likely will fall on deaf ears.

However, while the election ensured that the health reform game plan will remain in place on the federal level, the results also strengthened rebellion against health reform on the state level, which could complicate implementation efforts if Republications are ever able to push through revisions to the law, perhaps after mid-term elections in 2014.

Four states--Alabama, Florida, Montana and Wyoming--passed state referendums that direct their legislatures to limit the implementation of “Obamacare” by refusing to enforce the individual mandate measure in the health reform law that compels citizens to purchase health insurance. They join 16 other states that have already passed laws or made changes to their constitutions to say they will not enforce the individual mandate.

Those state referendums follow other state efforts to push back against health reform: In July, GOP governors from four states announced they would not build reform-mandated state insurance exchanges, which are envisioned to be online marketplaces where individuals can purchase insurance from a variety of plan choices. Most states, in fact, have been hedging their bets on insurance exchanges--37 states stopped or slowed their work on exchanges to await electoral results, estimates Bloomberg News.

So, President Obama’s re-election ensures that the strategic plans developed and investments made by stakeholders in anticipation of fundamental changes in the health care market were not made in vain. For health care I.T. and the broader health care market, the presidential election decided if the Supreme Court decision on health reform was the last federal word for the foreseeable future, or if many of the programs and federal investments in health care would be scaled back or halted. For now, it’s full steam ahead.

For more information on the Supreme Court’s decision on health reform and what that decision upheld, access our coverage on the ruling:

A Prescription for Health Care Information Certainty

Health Reform Analysis: I.T. Action Now Moves to ACOs, HIX Deployments, Population Health

What's Next for HIT after Reform Ruling: Challenges, Changes


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