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Grause: Supreme Court Decision

The U. S. Supreme Court answered a big health care question last week. It decided in the highly anticipated King versus Burwell case, that millions of Americans will be able to continue receiving federal subsidies to purchase insurance plans on federal exchanges.

For months, the question had loomed over almost everyone working in and watching health care – and especially those who rely on assistance to purchase insurance.

Because Vermont built its own exchange – even with all its challenges – the subsidies Vermonters receive to help purchase insurance were not in jeopardy. But people who live in the 34 states where the federal government operates their exchanges faced the real possibility of having to pay much more for health insurance based on the outcome of this case.

So at least for now the Affordable Care Act remains intact, and will continue to provide a solid foundation for continuing health reform efforts here and around the country. Now Green Mountain Care Board members, hospitals, doctors and others working to improve care and reduce health care costs can be confident that the federal laws governing these efforts will not shift out from under us.

Personally, I was encouraged to see a decision that reinforces Vermont’s efforts to achieve universal coverage. Too often, cost is a barrier to people needing health care. Vermont has the second-lowest percentage of uninsured residents in the nation, but we can’t stop until that number reaches zero – both because we know it’s the right thing to do and because when more people choose coverage and can help pay for that coverage, that’s good for the economy.

It’s a positive step toward achieving affordable health care for all, but if Vermont can find more ways to reduce costs and improve care here at home – perhaps the rest of the nation will follow.

We could, for example, work together within a coordinated community health model designed to avoid costly services such as hospital stays, and pay providers based on their ability to keep their communities as healthy as possible.

In light of the Court’s ruling, millions of Americans will still get subsidized health insurance. King v. Burwell is a signal that things are changing for the better.

In Vermont, where we have been leading the way for some time now in the effort to improve care while reducing costs, this is a green light for us to keep moving forward.

Bea Grause is head of the Vermont Association of Hospitals and Health Systems.
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