U.S. Supreme Court Dismisses Third ACA Challenge
From ACG Legislative and Public Policy Council Chair, James C. Hobley, MD, MSc, FACG
On Thursday, the U.S. Supreme Court dismissed the latest challenge to the Affordable Care Act (ACA) in 7 to 2 decision. Justice Breyer wrote the opinion. Chief Justice Roberts, Justices Thomas, Sotomayor, Kagan, Kavanaugh, and Barrett concurred. Justices Alito and Gorsuch dissented. This case was brought by various state attorneys general, alleging that the ACA is unconstitutional after Congress negated the financial penalty for failing to purchase health insurance. The Supreme Court dismissed the case on the grounds that the plaintiffs lacked standing to file a suit, as there is no actual injury.
The court considered three issues: Have the challengers suffered injuries that give them legal standing to bring the challenge? Did the changes Congress make in 2017 render unconstitutional the ACA’s requirement for individuals to buy insurance? And if so, can the rest of the law be separated out, or must it fall in its entirety? Since the plaintiffs did not establish the first issue, the Court did not address the other issues. From the opinion: The plaintiffs’ problem “lies in the fact that the statutory provision, while it tells them to obtain that coverage, has no means of enforcement. With the penalty zeroed out, the IRS can no longer seek a penalty from those who fail to comply….Because of this, there is no possible Government action that is causally connected to the plaintiffs’ injury—the costs of purchasing health insurance. Or to put the matter conversely, that injury is not ‘fairly traceable’ to any ‘allegedly unlawful conduct’ of which the plaintiffs complain.”
Other Policy Updates for ACG Members:
- The Occupational Safety and Health Administration (OSHA) recently issued a COVID-19 health care emergency temporary standard (ETS). This lays out requirements for workers in health care settings. Of note, this ETS includes surgical centers and practices, but there are various exemptions to the requirements. For example, the ETS does not apply to “non-hospital ambulatory care settings where all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter.” The ETS also provides exemptions for fully vaccinated employees from the masking, distancing and physical barrier requirements so long as there is not reasonable expectation that those employees should come in to contact with a COVID-19 positive individual. Is your practice impacted by these rules? This chart will help.
- The U.S. Department of Health and Human Services (HHS) recently revised the Provider Relief Fund (PRF) reporting requirements, allowing more time for providers to use the funds received and extending greater flexibility in provider reporting on the use of those funds.
- The Protecting Rural Telehealth Access Act (S. 1988), introduced this week by Senators Joe Manchin (D-WV), Joni Ernst (R-IA), Jeanne Shaheen (D-NH) and Terry Moran (R-KS), aims to improve access to and coverage of connected health services in rural parts of the country. The bill allows payment-parity for audio-only telehealth services for clinically appropriate appointments, permanently waives geographic restrictions in Medicare coverage (allowing patients to be treated in their homes), permanently allows Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to serve as distant sites for providing telehealth services, expand coverage for asynchronous (store-and-forward) telehealth services; and allows Critical Access Hospitals (CAHs) to directly bill for telehealth services.
Register Today from Upcoming FDA/ACG Public Workshops
From FDA Related Matters Committee Chair, Eric D. Shah, MD, MBA, FACG
Register today for the upcoming "Gastroenterology Regulatory Endpoints and the Advancement of Therapeutics VI (GREAT VI)" Workshops. The U.S. Food and Drug Administration (FDA) is partnering with ACG and other medical societies on two important GI workshops on July 21 and July 22.
The first workshop will be on eosinophilic gastrointestinal disorders. Discussions will focus on the following:
- The diagnosis and natural history of eosinophilic gastrointestinal disorders.
- Assessing clinical benefit in eosinophilic gastrointestinal disorders.
The second workshop will focus on celiac disease. Discussions will focus on the approach to drug development in celiac disease and include the following topic areas:
- The histologic endpoints to assess treatment benefit in patients with celiac disease.
- Regulatory framework for pediatric drug development in celiac disease.
- The role of gluten challenge in clinical trials
ACG at American Medical Association House of Delegates Meeting
This week, Bruce Cameron, MD, MACG and March Seabrook, MD, FACG represented ACG at the American Medical Association House of Delegates’ (AMA HOD) virtual meeting (June 11-16th). The AMA HOD meetings set the advocacy and public policy priorities for AMA leadership. ACG and the section council on digestive diseases cosponsored and supported resolutions impacting ACG members and patients, including:
- A new policy cosponsored by ACG and others to oppose the practice of insurance companies offering patients money to switch treatments from those recommended by their physicians. The AMA should now support legislation that would ban this practice, oppose legislation that would make these practices legal, engage with state and federal regulators to alert them to identified policies providing payments to patients as financial incentives to switch to payer-preferred drugs, and encourage state and federal regulators to prohibit or discourage such policies.
- Efforts to help hospital-based clinicians obtain greater access to outpatient formulary information.
- Efforts increase access to more peer-to-peer prior authorization requests.
- Policies supporting the use of telehealth services and make permanent telehealth waivers post-pandemic.
- Policies to further increase equity and inclusion in medicine.
- More flexibility and safeguards for clinicians from recently the HHS ONC information data blocking rules. What are these information blocking rules and how does impact you? Learn more from ACG's legal experts.
ACG Representatives to the AMA HOD at the last in-person meeting. From Left to Right: March Seabrook, MD, FACG and Bruce Cameron, MD, MACG.
ACG Board of Governors Elections: Vote Today!
From Vice Chair and Chair of the ACG Board of Governors Dayna S. Early, MD, FACG and Patrick E. Young, MD, FACG
The ACG Board of Governors Elections are open until July 6th. You received a separate email if there is an election in your state or region. Please take advantage of this unique ACG membership benefit and select a colleague who will best represent your state/region. Vote today!
Remember to contact your ACG Governor on important state and local issues impacting you and your practice.
The ACG Board of Governors is one of the most unique aspects of the American College of Gastroenterology. Governors are ACG Fellows that are elected from the membership of a particular state or region. There are currently 77 Governors across seven different regions in the U.S. and abroad. The Board of Governors acts as a two-way conduit between College leadership and the membership at-large. This helps the College make certain it is meeting the evolving needs of the membership.