Tossing out Pres. Obama’s healthcare law would have major unintended consequences for Medicare’s payment systems, unseen but vital plumbing that handles 100 million monthly claims from hospitals and other service providers, the administration has quietly informed the courts.

Although the law made significant cuts to providers and improved prescription and preventive benefits for seniors, Medicare has been overlooked in a Supreme Court debate focused on the law’s controversial requirement that individuals carry health insurance. Yet havoc in Medicare could have repercussions in an election year when both parties are avidly courting seniors.

In papers filed with the Supreme Court, administration lawyers have warned of “extraordinary disruption” if Medicare is forced to unwind countless transactions that are based on payment changes required by more than 20 separate sections of the Affordable Care Act.

Opponents argue that the whole law should go. The administration counters that even if it strikes down the insurance mandate, the court should preserve most of the rest of the legislation. That would leave in place its changes to Medicare, as well as a major expansion of Medicaid coverage.

Last year, in a lower court filing on the case, Justice Department lawyers said reversing the Medicare payment changes “would impose staggering administrative burdens” on the government and “could cause major delays and errors” in claims payment.

Medicare payment policies are set through a time-consuming process that begins with legislation passed by Congress. Even if Obama’s overhaul were completely overturned, the government still would have authority under previous law to pay hospitals, doctors, insurance plans, nursing homes and other providers.

“There is an independent legal basis to pay providers if the Supreme Court strikes down the entire law,” said Thomas Barker, a former Health and Human Services general counsel in the George W. Bush administration.

But reversing the new law’s payment changes from one day to the next would be a huge legal and logistical challenge, raising many questions. How would the government treat payments made over the last two years, when the overhaul has been the law of the land? Would providers have a right to refunds of cuts that had been made under the legislation?

Former program administrators disagree on the potential for major disruptions, while some private industry executives predict an avalanche of litigation unless Congress intervenes.

“Medicare cannot turn on a dime,” said former administrator Don Berwick, whose confirmation was blocked by Senate Republicans opposed to Obama’s law. “I would not be surprised if there are delays and problems with payment flow. Medicare has dealt with sudden changes in payment before, but it is not easy”...

Tom Scully, Medicare chief during former President George W. Bush’s first term, does not foresee major problems, although he acknowledges it would be a “nightmare” for agency bureaucrats.

“It is highly unlikely in the short term that any health plan or provider would suffer,” said Scully. “They’re probably likely to get paid more going forward. If you look at the way the law was (financed), it was a combination of higher taxes and lower (Medicare) payments. That’s what you would be rolling back.”

The White House declined to comment.

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Editor's Note: Once again, the Obama Administration is playing politics with the well-being of the nation and especially senior citizens, and all for the sake of a scare-tactic, politial talking point targeting seniors for the upcoming election...these people know absolutely no shame and, as far as we can discern, are self-serving, power-hungry and despicable...Oh, and by the way, Don Berwick, whom Mr. Obama entrusted with $962 billion dollars to head up the Centers of Medicare & Medicaid -- a job he was never approved by Congress to do -- was the ration-happy ideologue who said, “It’s not a question of whether we will ration care, it is whether we will ration with our eyes open.”


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