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