Saturday, July 7, 2012

ACA Update: US Supreme Court Ruling

By Emily McKinley, Health Information Specialist

As most of our followers know, the constitutionality of the Affordable Care Act (ACA) was argued in the US Supreme Court in March. On Thursday, June 28, the much anticipated ruling was announced, and simply put, the justices largely upheld the Act, which was signed into law in 2010.

In March, the Supreme Court heard four oral arguments regarding the act. Those arguments focused
on whether the individual mandate requiring all Americans to enroll in a health insurance plan was
constitutional; whether the mandate was even arguable at present or whether it fell under the Anti-
Injunction Act, which states that a tax cannot be challenged until it has been levied; if the individual
mandate was severable from the remainder of the act if found unconstitutional; and, finally, whether
the proposed Medicaid expansion and implications for federal funds is legal.

The Court’s ruling found that the individual mandate is constitutional, nullifying the arguments
pertaining to severability and the Anti-Injunction Act. The individual mandate is a provision of the ACA
that requires all Americans to obtain health insurance by 2014. Individuals may either purchase health
insurance through their employer or the state exchanges or, if income-eligible, may enroll in state and
federally funded programs. Those who do not meet this requirement will be required to pay a penalty,
which will be collected as part of their tax obligation.

On the remaining argument, Medicaid expansion, the Court ruled that states have the option to
participate in the program. The original provision required states to expand their Medicaid programs
such that individuals and families at or below 133% federal poverty levels were eligible for coverage.
In order to make this provision feasible, states will receive additional funding from the federal
government. The Court’s ruling allows states to choose whether they participate in the Medicaid
expansion without fear of being stripped of current federal, Medicaid-allocated funds; that said,
states who do not participate will not be entitled to additional federal funding. While this ruling allows
States flexibility, it may create hardship for low-income families and individuals as they struggle to find
appropriate coverage in non-participatory states.

Overall, however, the Court ruling was largely seen as a success among supporters of the ACA. After all,the law ensures coverage for individuals with pre-existing conditions, does away with lifetime limits,
provides preventative care, and protects families from financial ruin propagated by health care costs.
Further, it strives to make health insurance coverage affordable to all Americans. President Obama
stated, "(The) decision was a victory for people all over the country whose lives will be more secure
because of this law and the Supreme Court decision to uphold it."

For more information regarding the provisions of the Affordable Care Act, please visit http:// , or follow our blog,

We've embedded a document from the Catalyst Center that offers a concise description of many of the provisions in the ACA along with a side-by-side analysis of their implications for CYSHCN.


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