Health Care - Now What?

On June 28, 2012, the U.S. Supreme Court upheld the Affordable Care Act. They ruled the individual responsibility to have health insurance – the most controversial part of the law – was a constitutional exercise of Congress’ taxing and spending power. As a result of that finding, a majority of the Supreme Court ruled the law constitutional.

The Court did modify a new initiative in Medicaid, the joint federal-state program that provides health insurance for low-income citizens, people with disabilities, and the elderly. The Affordable Care Act expands Medicaid to more people with slightly higher incomes. This is the largest piece of the law’s nearly universal health insurance coverage.

The law provides extensive financial carrots to states to implement this new initiative. However, it also contains a big stick – loss of all current Medicaid federal funding to states that do not follow through. The Supreme Court ruled that crossed the line. According to the court, states now have the option of implementing the new Medicaid initiative.

What comes next for the Affordable Care Act? Simply, based on our system, the Supreme Court has the last legal word. However, there is still much to be done.

Many parts of the law need action both at the federal and state levels. Most importantly, many states still need to design their health insurance marketplaces so they are ready to go in 2014.

And the issue of Medicaid – a major part of the rural health care system – will be hotly debated in many states over the next year. We’ll keep you informed of the happenings, our opinions on those issues, and where you can make a difference.