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
What Now? Health Reform in the Aftermath of the Supreme Court Decision.
1. What Now? Health Reform in the
Aftermath of the S. Ct. Decision
Jaime S. King, JD, PhD
UCSF/UC Hastings Consortium on Law, Science and
Health Policy
June 29, 2012
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. 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. Health Law and Policy Initial
Implications
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
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
10. Exempt from the Individual
Mandate, but No Subsidy?
100% FPL
11.
12. Strategies to Undermine the
Health Law
Repeal and Replace Entire Bill
Repeal Portions of the Bill
Litigate HHS Regulations
Limit Appropriations