What the SCOTUS ACA ruling means for health consumers

Jane Sarasohn-Kahn

The post below ran on Health Populi on June 29. Disruptive Woman Jane Sarasohn-Kahn puts together a great piece on what the Supreme Court’s ruling on the Affordable Care Act means for consumers.

Now that the Affordable Care Act is settled, in the eyes of the U.S. Supreme Court, what does the 6-3 ruling mean for health/care consumers living in America?

scotusI wrote the response to that question on the site of Intuit’s American Tax & Financial Center here. The top-line is that people living in Michigan, where the Federal government is running the health insurance exchange for Michiganders, and people living in New York, where the state is running the exchange, are considered equal under the ACA’s health insurance premium subsidies: health plan shoppers, whether resident New Yorkers or Michiganders, can qualify for health premium discounts. This means that people shopping for health insurance under the ACA are all-American, whatever state they live in. The yellow and the white states, when it comes to insurance subsidies, are all one color now. (more…)

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ACA decision: Disruptive Women breaks it down for you

There’s a lot of coverage out there about the Supreme Court ACA ruling – more than anyone can possibly read. The staff at Disruptive Women has been following and analyzing the news for weeks, and working on some easy-to-read resources for our readers to help you wade through the information. In case you missed these, here’s a compilation of what’s on our blog.

Got a question for us? Leave a comment and our policy experts will answer!

Supreme Court score card »
A PDF that summarizes the views and votes of each Supreme Court justice, along with an explanation of the results.

Supreme Court Upholds Individual Mandate »
Disruptive Women’s coverage directly following the ruling.

Round-Up: Supreme Court decision on the Affordable Care Act »
Some articles and resources from various sources that we found helpful.

ACA Decision: Notable and Quotable »
Interesting quotes from the reaction statements of some top Congressmen and Senators, with links to the full statements.

Supreme Court Considers ACA »
A collection of resources we put together over time as the Court was deliberating, including links to the oral arguments, Supreme Court bios, a timeline of events, relevant articles and more.

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ACA Decision: Notable and Quotable

Following the Supreme Court’s decision to uphold the ACA, we read through the reaction statements of some top Congressmen and Senators. Here are some of the interesting quotes we found, with links to the full statements.


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Roundup – Supreme Court decision on the Affordable Care Act

In a 5-4 vote, the Supreme Court has upheld the Affordable Care Act, a decision that has many implications for the future of healthcare.  We’ve put together a quick round-up of resources to help break down the ruling and what it means to different people.

In case you missed it, you might want to take a look at the Justices’ opinion in full (PDF). And if the almost 200-page-long document is a little dense for you, thank goodness SCOTUSblog author Amy Howe has written it up in plain English.


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Supreme Court Upholds Individual Mandate

Despite conflicting reports early on, the Supreme Court upholds most of the Patient Protection and Affordable Care Act of 2010 (ACA), including the controversial individual mandate provision. A 5-4 ruling, Chief Justice John Roberts surprised many pundits by joining with the Court’s four liberal justices (Ginsburg, Breyer, Sotomayor and Kagan) to uphold the individual mandate as a tax.

“Simply put, Congress may tax and spend. This grant gives the federal government considerable influence even in areas where it cannot directly regulate,” Roberts wrote in the majority opinion. “The federal government may enact a tax on an activity that it cannot authorize, forbid or otherwise control.” The Court did not decide that Congress has authority under the Commerce Clause to require individuals to buy insurance, nor did they find that the mandate held up under the Necessary and Proper Clause.

However, as SCOTUSblog’s Amy Howe notes, “…Five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters.”

Because the mandate is upheld, the Court did not need to rule on severability, except for the Medicaid expansion provision, which would strip states of their Medicaid funding if they do not comply with new eligibility requirements. The Court ruled this provision to be constitutional so long as the states would only lose new funding (as opposed to all of their funding), a caveat that SCOTUSblog and others say narrows the parameters of the provision.

“The Constitution requires that states have a choice about whether to participate in the expansion of eligibility,” Howe explained to the SCOTUSblog’s livefeed audience of over 800,000. “If they decide not to, they can continue to receive funds for the rest of the program.”

From Roberts’ majority ruling: “Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.”

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Our readers weigh in: Supreme Court decision on ACA

As the Supreme Court’s decision on the Affordable Care Act approaches, we asked our readers to weigh in on what they think is going to happen. Turns out you have a lot to say! Here are a few of the great comments we got on Facebook.


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Timeline of Affordable Care Act and more

English: Barack Obama signing the Patient Prot...

Barack Obama signing the Patient Protection and Affordable Care Act at the White House on March 23, 2010. See our timeline for more important dates. (Photo credit: Wikipedia)

Like everyone else, we are closely monitoring the upcoming the Supreme Court decision on the Affordable Care Act. We have posted a number of new resources on the Disruptive Women site including a timeline of the ACA, biographies of the Justices, a recap of the oral arguments from March and a Supreme Court Score Card. Check back often for updates and new items.

In the meantime, what do you think will happen? Tell us what you think.


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Supreme Court Resources on the Affordable Care Act (ACA)

by Samuel Strongin. Here are a few resources that will help you better understand the foundation of what’s happening in the Supreme Court as well as the varying perspectives of each Justice.

Timeline of Patient Protection and Affordable Care Act (in PDF)

Supreme Court Justice Biographies (in PDF)

For more on the upcoming Supreme Court decision, visit our Supreme Court page.

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The Overlooked Mandate Issue

Mary R. Grealy

By Mary Grealy. While the U.S. Supreme Court was hearing oral arguments this week on the constitutionality of the individual mandate provisions of the Affordable Care Act, another serious concern about the mandate didn’t involve constitutional issues and stayed relatively unnoticed.

Is the individual mandate sufficient to achieve its intended goal, to bring healthy Americans into the health insurance pool?  In answering this question, the stakes are high.  If millions of currently uninsured Americans choose to remain without coverage, and simply pay the noncompliance penalty instead, serious questions are raised as to whether other insurance reforms can take effect – most importantly, eliminating pre-existing conditions as a barrier to coverage – without destabilizing the marketplace.

This is a legitimate worry.  In 2014, a person who chooses to remain uninsured would be penalized $95 or one percent of adjusted taxable income, whichever is greater.  And even when the penalty is fully implemented in 2016, the penalty will be the greater amount of $695 or 2.5 percent of adjusted taxable income.  These penalties will still be less than the cost of purchasing health coverage.

As University of Illinois law professor Richard L. Kaplan put it, accurately, “(A) person might choose not to buy health insurance, opting to wait until something medically unfortunate happens.  Insurance companies will not be able to refuse her at that point, a situation that might imperil the private insurance market.”

Even if the Court upholds the constitutionality of the individual mandate, lawmakers can’t complacently assume that it will be strong enough to move uninsured citizens into the insurance marketplace.  It would be worth studying the efficacy of other incentive programs, such as those used by the Medicare Part D prescription drug program.  Part D has utilized both limited enrollment windows as well as higher costs for those who delay enrollment.

The goal of incentivizing Americans to acquire health insurance is a good and necessary one.  It’s necessary, though, to keep in mind that the constitutionality of the individual mandate may be the most visible issue, but it’s far from the only one.

The post above ran first on the Prognosis Blog on March 30th.

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Weekly Roundup – March 30, 2012

By Carrie Winans. We know the Affordable Care Act’s (ACA) Supreme Court (SCOTUS) showdown was the only thing on most people’s radar this week, at least as far as health care and health policy news goes! We too were too caught up in the broccoli vs. okra debate, dissecting every known fact about Justice Anthony Kennedy (the likely “swing” vote) and trying to find a cat leash to be bothered by the other news headlines (highway Armageddon? didn’t faze us; Final Four? we’re back at Elite Eight?).

That’s why, for the round up, we decided to focus on a few things you may have missed while you were furiously refreshing your #ACA #SCOTUS tweet-stream.

Here are this week’s top non-ACA/SCOTUS health care and health policy headlines, at home and abroad…

At home:

Cancer in young people is devastating for all, and survivors are often shocked to learn that they are infertile after treatment. Reuters reports on why doctors are sometimes silent about this side effect.

If you are lucky enough to carry children, USA Today cautions you should be on the look-out for fatal heart attacks. A recent study shows that pregnancy increases your risk.

Your trip to the OB/GYN is about to get a lot more personal.  A PsychCentral study suggests that women should start talking to their gynecologist about how their sex life is going. By skipping out on those between-the-sheets details, you could be skipping out on catching early warning signs to many reproductive, menopausal and other health related issues.

Remember how much fun you had studying for your MCAT? USA Today reports that the party rages on as the MCAT changes to recruit holistic doctors who understand the effect of sociocultural factors on health.

Along with advising heart attack survivors to take a drink, doctors may now hand out Starbucks vouchers to their diabetic patients. Seems insane? The Huffington Post reports on a Harvard School of Public Health study that found coffee improves insulin sensitivity.


In England, a new study suggests that doctors who remove faulty breast implants should immediately replace them with new ones. If this course of action is implemented, it could cost UK tax payers millions.

Can you see your doctor prescribing two whiskeys a day to heart attack survivors? ABC News reports that the European Heart Journal believes it could work wonders.

And finally, this story may not be health-related, but take our word that you would regret if we let you miss it – CNN reports on what could quite possibly be the world’s smallest puppy.

Have a great weekend everyone and be sure to check back next week for all your health care and health policy news headlines, at home and abroad!

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One Account of the ACA Rallies at SCOTUS

The following is a guest post. It is the author’s perspective on the Affordable Care Act rallies that took place at the Supreme Court earlier this week and their viewpoint on the law itself. We invite you to submit your opinions and thoughts on this week’s SCOTUS events and the ACA by commenting on this post.

By Paris Bienert. As a sophomore at the George Washington University I have lived in the nation’s capital for almost two years now, and in all that time I had not found an event that warranted waking up earlier than the sun. On Tuesday, though, for the first time there was an event I felt I could not ignore. A few days earlier, I had received an email asking me to partake in a rally at the Supreme Court to support the Affordable Care Act. As a college student, as a woman, and as an American, I could not pass up this opportunity to express my beliefs.

At the rally, fellow supporters of the law, most of whom hailed from pro-choice groups such as NARAL Pro-Choice America and Planned Parenthood, marched in a circle holding signs and chanting. Weaving in and out of the same area were Tea Partiers, pro-lifers, and other opponents of the law, all chanted in opposition of the supporters.

With posters in hand, my roommate and I joined in the circle of marchers; we were timid at first, but within seconds we were captivated by the crowd’s energy and began partaking in the passionate cheers led by supporters of the law. Of all the different chants, my favorite was a rhythmic mantra of “The health law works for you! The health law works for me! The health law works for every American family!”

Even though what we were chanting was fair, un-provocative, and – dare I say – true, many of the opponents responded with assertions that were unnecessarily extreme and hurtful, not to mention some that were downright untrue. For example, one pro-lifer proclaimed into the microphone that all of us pro-choicers are completely against all human rights, a claim which, in my opinion, is entirely nonsensical.

I would like to take a moment just to counter some of the accusations directed at me during the rally: No, I do not hate freedom. No, I do not support tyranny. But yes, yes I do support the Affordable Care Act. (more…)

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SCOTUS – Day Three of Oral Arguments

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SCOTUS ACA Oral Arguments: Day 2

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SCOTUS ACA Oral Arguments: Day One

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Happy Birthday Madam ACA!

Rozalynn Goodwin

By Rozalynn Goodwin. My employer was asked for a statement acknowledging the second anniversary of federal health reform. Here was my suggestion.

“Happy Birthday to South Carolina’s mistress, the Affordable Care Act! We use and enjoy your goods in the dark, but despise and won’t claim you in the daylight.”

For the life of me, I can’t understand why our communications team didn’t see value in using it. No hard feelings though…

We South Carolinians don’t take too well to anybody telling us what to do. We are very proud to have been the first state to secede from the Union. Our relationship with federal health reform is no different.

“We will continue to push back against the federal takeover of our healthcare system. South Carolina does not want, and cannot afford, the President’s healthcare plan. Not now, and not ever,” South Carolina Governor Nikki Haley, January 2012

Yet, South Carolina has received over $101 million dollars from “Obamacare” for health care grants, demonstration projects and programs. Not the mention the $13 million in rebates our seniors received for Medicare prescription drug coverage, plus another $32 million in brand name prescription drug savings. And I haven’t even mentioned the 40 plus businesses (including Blue Cross Blue Shield of South Carolina) that have taken advantage of the Act’s Early Retiree Reinsurance Program, or the over 30,000 young adults who have received coverage as a result of the new law. But, remember, “We don’t want the President’s healthcare plan.”

Dear South Carolina and all other states talking out both sides of your mouths:

While Madam ACA has her flaws, I believe she has good intentions. She’s so young and vulnerable, and doesn’t deserve the verbal onslaught she’s received, especially during this presidential primary marathon. It’s time to come clean about your relationship with her. Take her home to meet the family. Heck. Once they meet her, they might even like some of her qualities, and help you two work out your differences for an open and honest relationship that benefits us all.

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