The U.S. Supreme Court issued a much awaited decision today upholding the constitutionality of the Affordable Care Act (ACA), Obama’s signature domestic policy initiative. The court ruled to uphold the entirety of the ACA, including the individual mandate for all Americans to purchase insurance (which the court considered a tax), with one exception regarding the federal government’s power to terminate states’ Medicaid funds (the joint state-federal program to provide health coverage to poor and disabled people) if they refuse to expand coverage to more people.
Most of the provisions in the law will impact younger adults (remember, people over age 65 have universal health care — Medicare!), but older adults will continue to receive a discount on prescriptions drugs included in the law. The law also includes many important provisions supporting development of innovations in long term care (like culture change) as well as transparency, access, accountability and quality for long-term care consumers.
While partisan politics will undoubtedly overshadow today’s news, here’s a quick summary of major provisions included in the law:
- The individual mandate to own health insurance goes into effect 2014.
- For people who have insurance, nothing changes except the insurance company can’t drop you if you get sick and it can’t cap your lifetime benefits.
- Insurance companies can’t discriminate against kids with pre-existing conditions.
- Young adults can stay on their parent’s health insurance until age 26.
- Insurance companies are required to provide preventive care like mammograms.
The big question regards the Medicaid expansion provision. Several million uninsured Americans would have qualified for coverage under the Medicaid expansion provision, but the court struck down the penalty of stripping all Medicaid money from states who refuse to expand coverage. The provision remains intact but, with no penalties for the federal government to enforce for noncompliance, it is not likely states will comply.
This ruling certainly doesn’t settle the debate over healthcare by a long shot, and upholding the ACA doesn’t solve the nation’s long term challenge of keeping critical safety net programs like Medicare solvent. But the uncertainty over the law’s constitutionality is over and many provisions intended to improve access and quality of health care can now move forward.