Long term care providers await the U.S. Supreme Court’s decision on whether President Barack Obama’s health care reform law is unconstitutional. Texas is one of the states that filed suit against the federal government challenging the law. The key issue is the law’s individual mandate, which would require individuals to purchase health care insurance or face fines. The Physicians Hospital of America, which represents doctors, are concerned about the law’s restriction on expanding or building new physician-owned hospitals.
MedPage Today breaks down the possible court decision scenarios. The least likely outcome, according to MedPage, would be the removal of the Medicaid expansion. Under the new law, millions more Americans would be eligible for Medicaid. The most likely outcome? Probably striking down the most controversial portion – the individual mandate:
Under this scenario, the law’s most controversial provision — the mandate that everyone must have health insurance or else pay a penalty — would be ruled unconstitutional, but everything else in the law — including the insurance market reforms, health insurance exchanges, and subsidies for those who can’t afford insurance — would remain.
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During oral arguments on the issue — known as the mandate’s “severability” — the Supreme Court justices enunciated these differing positions.Justice Elena Kagan asked, “Isn’t a half of loaf [of bread] better than no loaf?”
No, said Paul Clement, the lawyer for the 26 states that are suing the federal government over the law. Sometimes no loaf is indeed better than half a loaf, he said. In the case of the ACA, the mandate is too integral to the overall survival of the whole law.
“If you don’t have the individual mandate to force people into the market, premiums will skyrocket,” Clement said during oral arguments in March.
Clement and the Obama administration agree that without forcing young and healthy people into the insurance market, many would not buy insurance. That would mean the insurance pool would largely be comprised of less-healthy people, which would cause insurance to be more expensive for everyone.