The Supreme Court and Health Reform

A Message from ACG President, Lawrence Schiller

Dear Colleagues:

Today, Thursday June 28, 2012, the U.S. Supreme Court released its decision on the constitutionality of the Patient Protection and Affordable Care Act (now known as the “ACA”). The ACA was signed into law in March 2010 and contained many provisions impacting clinical gastroenterology and the patients that we serve.

In a 5-4 ruling, Chief Justice John Roberts joined Justices Elena Kagen, Ruth Bader Ginsburg, Stephen Breyer, and Sonia Sotomayor in holding that Congress was acting within its constitutional powers in requiring Americans to purchase health insurance or face a penalty. Of interest, the Court did not uphold the law under the Commerce Clause, but instead, chose to uphold the law under the “taxing clause” of the Constitution, which allows Congress to lay and collect taxes.

The Court also ruled that Congress cannot withhold current federal Medicaid dollars if states fail to comply with the ACA’s expansion of Medicaid eligibility requirements. Although this expansion is being subsidized by the federal government, states will have the option of refusing to participate.

The President has stated that implementation of the ACA will continue as planned. It is unlikely that Congress will be able to repeal the law this year and even if it attempts to do so, the President can veto that legislation. Physicians need to proceed with the expectation that the ACA will come into effect as planned over the next few years.

How does the Court’s decision impact clinical gastroenterology?

The ACG staff has provided a detailed analysis of today’s ruling and how the decision specifically impacts GI clinicians and our profession. Please click here to read this analysis, “The U.S. Supreme Court Decision & Patient Protection and Affordable Care Act: What It Means for Clinical Gastroenterology.”

Please also continue to monitor ACG Updates for information on this milestone event in health care policy.


Lawrence R. Schiller, MD, FACG
American College of Gastroenterology