What Now? Health Reform in the Aftermath of the Supreme Court Decision.

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Overview of the ACA legislation recently ruled on by the UC Supreme Court. By Jaime S. King, JD UCSF / UC Hastings Consortium on Law, Science and Health Policy. http://www.uchastings.edu

Published in: Economy & Finance, Business
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What Now? Health Reform in the Aftermath of the Supreme Court Decision.

  1. 1. What Now? Health Reform in theAftermath of the S. Ct. DecisionJaime S. King, JD, PhDUCSF/UC Hastings Consortium on Law, Science andHealth PolicyJune 29, 2012
  2. 2. Two Major Holdings Individual Mandate upheld  4 Justices upheld it via the Commerce Clause (Ginsburg, Sotomayor, Kagan, and Breyer)  Chief Justice Roberts upheld it as a tax. Medicaid Expansion  Federal government may incentivize the expansion  Roberts, Kagan, Breyer, Ginsburg, Sotomayor  But, the Federal Government cannot withdraw all Medicaid funds for failure to expand  Roberts, Kagan, Breyer, Scalia, Alito, Kennedy, Thomas
  3. 3. Major Elements of the ACA Upheld Individual Mandate Employer Mandate/Play or Pay Premium and Cost Sharing Subsidies Medicaid Expansion (limited) Health Insurance Exchanges No Preexisting Condition Exclusion Community Rating Dependents can stay on insurance until age 26 Payment Changes in Medicare
  4. 4. Health Law and Policy InitialImplications 2014 – Nearly all individuals will have to purchase health insurance or pay a tax. Medicaid Expansion – Opt In State Exchanges – Back on Track Future Litigation/Repeal Efforts
  5. 5. No “Broccoli Horrible”
  6. 6. Mandate vs. Tax
  7. 7. Medicaid Expansion – Opt In Prior Medicaid Eligibility ACA Disabled  All individuals with incomes under 133% of the Federal Blind Poverty Level Families with Children Elderly  ACA Following S. Ct. Ruling  133% only if state decides to expand
  8. 8. What will the States do?
  9. 9. Medicaid/Tax Credit Ineligible? $15,000 Total Income for 2  $90,000 Total Income for 4
  10. 10. Exempt from the IndividualMandate, but No Subsidy? 100% FPL
  11. 11. Strategies to Undermine the Health Law Repeal and Replace Entire Bill Repeal Portions of the Bill Litigate HHS Regulations Limit Appropriations
  12. 12. Difficult to Repeal andReplace All of it….
  13. 13. Is This the End of the Fight? Repeal and Replace Entire Bill Repeal Portions of the Bill Litigate HHS Regulations Limit Appropriations
  14. 14. Intersection of Law, Scienceand Health Policy

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