Friday, 29 June 2012
Supreme Court Upholds ACA
The health care law stands. As you undoubtedly know by now, the Supreme Court of the United States in a five-to-four decision yesterday, upheld President Barack Obama's Affordable Care Act.
Although it is a giant victory for President Obama and the people of the United States, there are complications. Expansion of Medicaid was rejected and that was a more nuanced decision than I'm prepared to discuss today.
There are many dozens of places online where you can read details, explanations and commentary of the decision, and the full, 193-page decision is posted at the Supreme Court website [pdf].
Most importantly, the individual mandate was upheld but there are questions. It was not under the Commerce Clause that it remains Constitutional, but under Congress's power to tax.
So apparently, if people do not purchase coverage, there is a consequence – a significant tax to be paid. However, there is no penalty for not paying the tax. Or maybe there is. News reports I saw and heard on that point conflict with one another and I haven't had time to follow up yet.
For elders, all our gains from the health care act continue: free, annual, wellness examinations and free or low-cost health screenings such as mammograms, bone-density measurements, diabetes, HIV and obesity screenings among others.
The doughnut hole in the prescription drug plan (Part D) will continue to gradually close and Medicare Advantage plans cannot charge more for chemotherapy, dialysis and some other procedures than allowed under Medicare Parts A and B.
According to the National Committee to Preserve Social Security and Medicare (NCPSSM), the solvency of Medicare has been extended eight years thanks to this legislation.
One provision I like a lot in today's awful economy is that parents can continue to carry their children under age 26 - more than three million of them - on their health insurance policies. That, of course, continues too.
The Affordable Care Act is nowhere near perfect. I believe a better way to go is single payer, Medicare for All or something similar and I do believe it will be necessary in the future to move in that direction. But now, with this Court decision, that will not happen while I still walk the Earth and this is best we've got. It's better than what the Republicans prefer.
Because I was out of the house most of Thursday with meetings and other obligations, I haven't yet had much opportunity to think about the Court's decision and write anything useful or informative. So I am leaving that in your capable hands today.
What was your reaction to the decision? What did you learn or take away from any of the reporting and commentary? What about the Republican threat to repeal the ACA - is that just defeat bluster or will they try to do it?
What's your take on Justice John Roberts' left-leaning decision and does it signal a change in his future deliberations? How will this decision change healthcare in the U.S. overall? What kind of effect will it have on the presidential election campaign?
Oh, and you might want to comment too on yesterday's nasty bit of business in the House of Representatives instigated by Representative Darrell Issa (R-CA) voting to hold Attorney General Eric Holder in contempt over - well, nothing. I was mildly cheered to read that a whole bunch of Democrats walked out rather than dignify the proceeding with their votes.
I'm curious and eager to hear from you all and to read your back-and-forth on this.
At The Elder Storytelling Place today, Terry Hamburg: Passing Through Puberty