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Transcript of It_s A Hot Mess-1
8/2/2019 It_s A Hot Mess-1
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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?
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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.
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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.
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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
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