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It’s A Hot Mess

What the Supreme Court ruling on the Health Care Act means for you

This is a big deal. No, really. And I completely understand, reading up on health

insurance isn’t the most fun thing to do with your downtime. Let the insurance cats help

you through. Cat Face knows exactly how you feel.

A Quick Overview

As you know, the Supreme Court

recently heard arguments for and against

the Affordable Care Act (ACA; also

known as the Health Care Act, Patient

Protection and Affordable Care Act,

Obamacare). A ruling from the court is

expected in June of this year.

At the heart of the argument are two

main pieces of the ACA:

1.) The individual mandate: a

requirement within the law, that

in 2014, all individuals who meet

established income guidelines

must purchase health insurance,

or pay a financial penalty.

Within the ACA, states areallowed to create insurance

exchanges where individuals and

small businesses can find and

purchase health insurance plans.

Each Side’s Argument in a Nutshell: the

individual mandate

Basically, opponents of the individual

mandate argue that Congress cannot

‘force’ people to purchase a productfrom a private organization, and that the

individual mandate infringes on

individual liberty.

For example, if the government is allowed to require citizens to purchase services or

items, where does it stop? Could the government later mandate that individuals must

purchase cell phones, for instance?



On the government’s side, the argument is that under the Constitution's Commerce

Clause, Congress is allowed to regulate activity that has a substantial effect on interstate

commerce. Since health insurance is big business, and certainly crosses state lines, the

government feels it has the power to require individuals to purchase health insurance.

2.) The expansion of Medicaid: In essence, the ACA redefines who is eligible for

Medicaid based on income levels. This expansion is estimated to include an

additional 16 million U.S. residents.

Each Side’s Argument in a Nutshell: the expansion of Medicaid

Opponents argue states’ rights hang in the balance; essentially can the Federal government

require states to comply, and change the terms of Medicaid eligibility for individuals, and

if states don’t comply, they face a loss of funding? (Medicaid is a federal-state program,

where the federal government provides the majority of funding, and each state oversees

the program.)

On the government’s side, the argument is that state participation in the Medicaid

program is voluntary. And, the Federal government is within its rights to require state

compliance in exchange for funding.

What the Supreme Court will be

determining…

1.) Under precedent set in the

1800’s, the Supreme Court

will first be looking atwhether or not a ruling can

even be made at this point.

Case in point, the

individual mandate does not

go into effect until 2014, so

can the Court make a ruling

at this time?

2.) If it does decide a ruling can

be made, the Court will look at the constitutionality of the individual mandate.

3.) The next consideration deals with a term called “servability”. Basically, if theindividual mandate is ruled unconstitutional can the rest of the ACA stand on its

own?

4.) Fourth, the Court will decide if the Medicaid expansion is constitutional.

Possible Decisions from the Supreme Court

So, what does all this mean for you? There are several ways this could go.



A.) The Supreme Court determines a ruling cannot be made yet. Everything within the

act continues on schedule until the individual mandate has been enacted. For an easy

timeline of the ACA implementation, and what it provides and requires, check out this

link .

B.) The Supreme Court rules that either the individual mandate or the Medicaid expansionis unconstitutional, and the rest of the ACA cannot stand on its own. The ACA is dead,

meaning no individual mandate to buy insurance, no Medicaid expansion, and no further

implementation of the law. Plus, current projects that have already received funding

under the ACA, like the electronic system implementation, risk losing funding.

C.) The Supreme Court rules that the individual mandate is unconstitutional, but the rest

of the law stands. Individuals will not be required to buy health insurance. But, analysts

of this issue warn that without the individual mandate the ACA as a whole will cost too

much, and be unsustainable. Plus, the expansion of more Medicaid recipients may put

too much strain on the health care system, as there may not be enough doctors to meetthe increased demand, lowering quality of care.

D.) The Supreme Court rules that the expansion of Medicaid is unconstitutional, but the

rest of the law stands. There will be no expansion of Medicaid, and health insurance may

still remain out of reach for many. If the individual mandate remains active in this

scenario, many individuals may not meet income requirements and may face financial

penalties.

E.) The Supreme Court rules that the ACA as a whole is constitutional. All provisions of

the law will be enacted, including the individual mandate and Medicaid expansion. Allindividuals who meet the income standards must purchase health care insurance beginning

in 2014, or pay a financial penalty. As for the Medicaid expansion, an additional 16

million people are projected to be eligible for Medicaid under the ACA.

I know, I know. Like, I said, it’s a hot mess. But,

no one is arguing that the health care system isn’t

in need of reform. This is a monumental issue, and

is sure to be a landmark ruling.

Now we wait to see what happens in June.Thoughts or ideas on this, feel free to share here.

This and That

Beyond the Supreme Court, there’s another

question being asked. How much is this going to

cost? A recent study argues that the ACA will

increase the deficit. You can see that article here.



In all fairness, I am looking for a fact sheet, article, study, etc. on the ACA proponents’

side that gives an overview of how the ACA is being funded. If you find one, please

share that link here.

Resources

http://www.healthcare.gov/law/timeline/#event1-pane

http://www.boston.com/news/nation/washington/articles/2012/04/10/study_obamas_health_care_law_would_raise_deficit/

http://topics.nytimes.com/top/reference/timestopics/organizations/s/supreme_court/affordable_care_act/index.html

http://pnhp.org/blog/

http://www.nejm.org/doi/full/10.1056/NEJMp1114933

http://www.himss.org/ASP/ContentRedirector.asp?type=HIMSSNewsItem&ContentId=79807

http://www.cahc.net/2012/03/aca-on-trial-part-ii-possible-outcomes.html

http://www.sodahead.com/united-states/is-obama-to-blame-in-judges-health-care-ruling/question-1387801/?page=10&link=ibaf&q=health+insurance+humor&imgurl=http://2.bp.blogspot.com/_4s5pmFL_ZlQ/THErWu10syI/AAAAAAAAEL8/QRDn9DcwtvU/s1600/HEALTH%252520CARE%252520REFORM%252520universal%252520single%252520payer

%252520barack%252520obama%252520healthcare%252520motivational%252520posters%252520funny%252520hot%252520gag%252520humor%252520demotivational%252520walpaper%252520web%252520sites%252520cartoon%252520parody%252520parodize%252520public%252520option.jpg

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