The Affordable Care Act: Federal Next Steps

Tuesday - 7/31/2012, 6:16pm EDT

August 2, 2012

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On June 28, the Supreme Court handed down its rulings on the four legal challenges to the Affordable Care Act (ACA), finding in favor of defendants on the central issue of the individual mandate and upholding the balance of the law with the exception of federal power to terminate states' Medicaid funding. Learn more about the Affordable Care Act, potential implications for government agencies with health oversight, and immediate steps that governments may take in the aftermath of the rulings.

Guests:

Kelvin Womack, Principal and Federal Health Practice Leader, Deloitte Consulting LLP
Diane Murray,, Principal, Deloitte Consulting LLP



Show highlights:

• Overview of the Supreme Court ruling on the Affordable Care Act
• Potential implications for Federal organizations impacted by the ACA
• Need for collaboration across Federal, State, and commercial health care
• Key activities Federal organizations need to move forward as a result of the Supreme Court ruling

The following is a full transcript of FedCentral' s interview with Kelvin Womack, Principal and Federal Health Leader, Deloitte Consulting LLP and Diane Murray, Principal and IRS client service lead, Deloitte Consulting LLP conducted by Jane Norris on August 2, 2012. To listen to the full interview go to http://www.deloitte.com/us/fedcentral.

Jane Norris
Welcome to FedCentral, brought to you by Deloitte, a program where executives and federal government leaders talk about the issues and initiatives that are making a real impact on the business of government today, to help government help America.

On June 28th, as most of you know, the Supreme Court handed down its rulings on the four legal challenges to the Affordable Care Act, finding in favor of defendants on the central issue of the individual mandate and upholding the balance of the law with the exception of federal power to terminate states' Medicaid funding. Today, we're going to discuss the implications of the Supreme Court and the federal government. We'll also talk about the Supreme Court ruling on the Affordable Care Act, potential implications for government agencies with health oversight, and immediate steps that governments may take in the aftermath of the rulings.

Joining us today to discuss the Supreme Court ruling is Kelvin Womack. Kelvin is a Principal with Deloitte Consulting and leads the Federal Health Sector and serves as its practice leader. Mr. Womack also serves as a federal health reform executive leader helping federal health clients address their needs related to health reform legislation.

And Diane Murray, who's a Principal with Deloitte Consulting. She leads the IRS account, and she's helping the IRS with business and technology changes required to support the health reform legislation. Welcome to you both. Thanks for joining us today.

Kelvin Womack
Thank you.

Jane Norris
Well, there's a lot going on, so Kelvin, why don't you give us an overview of the Supreme Court ruling and what it means for federal agencies.

Kelvin Womack
Okay, thanks, Jane. Well first of all, as I think many of us know, the Court found in favor of the defendants on the central issue of the individual mandate and upholding the balance of the law with the exception of the federal power to terminate states' Medicaid funding, so that was one thing that came out of it.

Second thing was the majority of the Court decided that the Anti-Injunction Act did not apply. The Court did not vote on the question of whether the mandate was severable from the rest of the law because the mandate was upheld, and thirdly the challenge to the federal government's power to require minimum Medicaid eligibility for the states at 133% of the federal poverty level was limited but it was no invalidated. The Court ruled that the states have a choice to participate in the expansion of Medicaid since the federal government does not have the power to revoke existing Medicaid funds if a state chooses not to participate.

Jane Norris
Alright, so from a federal government agency perspective, what are the next steps that the government will have to engage in, in order to implement the Affordable Care Act or are they already well down the road?

Kelvin Womack
So I think, Jane and Diane, they are already well down the road. What this decision did was it removed a lot of uncertainty from the feds as to how they were going to move forward if, in fact, any portions of the law had not been upheld by the court. They've got a full plate. In the next 18 months, there are a lot of things that they need to get done and when I say 'they,' there are several federal agencies. It's not just the Department of Health and Human Services. Diane serves with the Internal Revenue Service, and we'll talk about some of the things they had to do, but our federal clients have a lot of work to do together collaboratively over the next 18 months to get health insurance exchanges implemented and out— and a lot of other things dealing with some of the public health prevention activities that this law provides, as well.

Jane Norris
So talk a little bit, if you would, Diane, about the number of agencies that are going to be engaged.

Diane Murray
Oh, gosh, probably at least six or seven, if not more. We've got HHS, we've got the IRS, we've got the Department of Homeland Security. Kelvin, can you think of others?

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