With the Supreme Court expected to rule on President Obama’s 2010 health care law within the next two weeks, House Republicans are scrambling to oppose any part of the law that is enacted. Republicans plan to force a vote to repeal the law immediately if it survives the Supreme Court. While vehemently opposing the law from its inception, Republicans seem to offer little in the way of alternatives, merely favoring a ‘wipe the slate clean approach’, and leaving the White House to deal with any contingency plans for those left behind (i.e. those with pre-existing conditions).
Democrats remain optimistic that the law will pass, but are making their own provisions if the final decision is unfavorable. Ready to defend the law, Democrats are carrying fact cards touting the numbers of Americans that have already reaped benefits from the health care law such as:
- 86 million people have received free preventive care
- 105 million no longer face a lifetime cap on benefits
- 17 million children are no longer denied benefits based on pre-existing conditions
The specific aspects of the law the Supreme Court must consider include:
1) Are the health law’s penalties (for those that choose not to buy into a health care plan) actual taxes and if so, is it too soon to be challenged in court? The Anti-Injunction Act says that taxes cannot be challenged in court until they are first levied. The penalties would be due starting in 2015.
2) The Court will decide if a mandate that requires most people to have health insurance, or else, pay an annual penalty, is even constitutional. Opponents say the federal government cannot force people to buy a product or service.
3) How much of the law, if any, will be cut?
Advocates of the law wish to remind voters that no matter the outcome of the Supreme Court decision, the heart of the law will likely not be impacted, which is healthcare for the uninsured through Medicaid expansion, state-run health insurance, and tax subsidies for purchasing private insurance.
No doubt the Supreme Court’s decision will have resounding affects for years to come on public health, insurance companies, the Obama Administration’s legacy and re-election campaign, and 46 million uninsured Americans.
The New York Times outlined the possible outcomes of the upcoming decision (to read more click here)
|Eliminate Mandate Only||Eliminate Mandate and Provisions||Strike Down the Entire Law|
|People||People who do not want to buy health insurance would not be penalized if they don’t. Premiums could be higher in the individual market.
|Many people with serious pre-existing conditions could still have difficulty obtaining or affording coverage.
|Popular consumer provisions, such as free preventive care and extended coverage for young adults, would no longer be guaranteed by law.
|Insurers||This is a nightmare outcome for insurers, who fear the burden of covering sicker people without a large pool of healthier people to offset the cost.
|This option would address concerns of the insurers, who say the market reforms are inextricably linked to the mandate and would not work without it.
|Some large insurers have said they will continue to offer some popular coverage changes already in effect.
|Health Care Providers||The law has spurred structural changes for health providers since 2010, and many of those changes are here to stay even if portions of the law are not. Some hospitals have prepared for more patients by hiring doctors and upgrading computer systems. There would be some uncertainty until it becomes clear how Congress may react.
|The law has spurred structural changes for health providers since 2010, and many of those changes are here to stay even if portions of the law are not. Some hospitals have prepared for more patients by hiring doctors and upgrading computer systems. There would be some uncertainty until it becomes clear how Congress may react.
|This would be disruptive for health care providers, since most have begun to carry out the changes envisioned in the 2010 law.
|States||The state insurance exchanges required by the law rely on the mandate to calculate rates and attract a pool of users. States could choose to enact their own laws that require or encourage residents to buy insurance before they need it.
|The state insurance exchanges required by the law rely on the mandate to calculate rates and attract a pool of users. States could choose to enact their own laws that compel or encourage residents to buy insurance before they need it.||States that have been investing in their exchanges would have to decide whether to continue.