Arthur Gianelli, president and chief executive of NuHealth System, which...

Arthur Gianelli, president and chief executive of NuHealth System, which runs Nassau University Medical Center in East Meadow (Dec. 8, 2009) Credit: Newsday/Karen Wiles Stab

It is impossible to tell what impact today's Supreme Court decision on the Affordable Care Act will have on the presidential election. But it is not too early to say what the ruling means for patients and providers. This decision affirms the constitutionality of single most important piece of social legislation since the passage of Medicaid and Medicare nearly half a century ago.

As commentator Jonathan Alter tweeted, "We have ended discrimination against sick people in our time."

Today's ruling, while potentially limiting the expansion of the Medicaid program, does clear the way for the creation of state-level health insurance exchanges. These exchanges will expand partially subsidized insurance coverage and fix the individual and small group insurance markets, the markets that -- until now -- were fatally compromised by adverse selection and uncontrolled insurance costs.

But in many respects, the court's decision simply amplifies the momentum that has already gathered behind the fundamental reform of the American health care-delivery system. Reform efforts all across the country are transforming hospitals like the Nassau University Medical Center, the hospital which I run.

Such efforts are essential if we, as Americans, are going to obtain the best possible outcomes at costs that we, and future generations, can afford. So in the coming years, I expect that my hospital will get smaller, it will emphasize community-based primary care instead of inpatient services, it will partner with other providers to manage the care of vulnerable populations, it will be integrated clinically with the North Shore-Long Island Jewish Health System, and it will be committed to "bending the cost curve" by improving, each and every day, the quality of care it delivers to its patients.

Today's ruling means these reforms can continue at their already staggering pace, assured of needed federal financial support and, now, with the welcomed imprimatur of the Supreme Court.

Arthur A. Gianelli is president and chief executive officer, NuHealth, operator of the Nassau University Medical Center in East Meadow.


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