In its long-awaited ruling this morning, the U.S. Supreme Court ruled that the individual mandate in the Patient Protection and Affordable Care Act (PPACA) is a constitutional exercise of Congress’ right to imposes taxes. Almost all of the law will stand. The only exception is that states are no longer required to expand Medicaid to cover low-income single adults. States who chose not to do so will not be penalized by losing all of their federal Medicaid funds.

TMA President Michael Speer, MD, issued this statement to the news media as he prepared to handle an onslaught of interview requests:

“One thing today’s ruling has not, and cannot, change is Texas physicians’ deep commitment to care for our patients. The well-being of our patients comes first.

“The Texas Medical Association has said since day one that we need to find what’s missing, keep what works, and fix what’s broken in the new law. We absolutely must reduce the law’s red tape and bureaucracy that interfere with patient care. Today’s health care system is riddled with hundreds of regulations imposed by federal health law that do little to improve patient care but instead divert our time and energy away from our patients.

“The court gave the states flexibility on Medicaid expansion. We desperately need a better system of caring for Texas’ large uninsured population. We need a local/state/federal partnership to design a fair and sustainable system. Top-down mandates are not the answer.

“Specifically, at this critical juncture for our health care system, the physicians of Texas recommend that Congress and the Texas Legislature:

• Protect important consumer insurance protections, such as insurance product labeling and protections for patients with preexisting conditions;
• Immediately fix the broken Medicare physician payment formula;
• Enact Texas-style liability reforms for the rest of the nation;
• Allow Medicare patients to contract directly with their physicians for any covered service;
• Scrap the Independent Payment Advisory Board;
• Lift restrictions on physician hospital ownership;
• Help fund the huge need for more physicians to care for America’s growing, elderly population; and
• Rebuild the Medicaid physician network by enacting competitive Medicaid and Children’s Health Insurance Program physician payments.”