SCOTUS DECISION - US Supreme Court Rules on Healthcare Act

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SCOTUS DECISION – US Supreme Court Rules on Healthcare Act

SCOTUS DECISION – US Supreme Court Rules on Healthcare Act

H/T Reuters Alison Frankel

NATIONAL FEDERATION OF INDEPENDENT BUSINESS et al.

v.

SEBELIUS, SECRETARY OF HEALTH AND HUMAN SERVICES, et al.

Nos. 11–393, 11–398 and 11–400
United States Supreme Court.
Argued March 26, 27, 28, 2012
Decided June 28, 2012FN1

SyllabusFN*

FN*The syllabus constitutes no part of the opinion of the Court but has been prepared by the Reporter of Decisions for the conveni-ence of the reader. See United States v. De-troit Timber & Lumber Co., 200 U. S. 321, 337.

In 2010, Congress enacted the Patient Protection and Affordable Care Act in order to increase the number of Americans covered by health insurance and decrease the cost of health care. One key provision is the individual mandate, which requires most Ameri-cans to maintain ?minimum essential? health insur-ance coverage. 26 U. S. C. §5000A. For individuals who are not exempt, and who do not receive health insurance through an employer or government pro-gram, the means of satisfying the requirement is to purchase insurance from a private company. Begin-ning in 2014, those who do not comply with the mandate must make a ?[s]hared responsibility pay-ment? to the Federal Government. §5000A(b)(1). The Act provides that this ?penalty? will be paid to the Internal Revenue Service with an individual‘s taxes, and ?shall be assessed and collected in the same manner? as tax penalties. §§5000A(c), (g)(1).

Another key provision of the Act is the Medicaid expansion. The current Medicaid program offers fed-eral funding to States to assist pregnant women, children, needy families, the blind, the elderly, and the disabled in obtaining medical care. 42 U. S. C. §1396d(a). The Affordable Care Act expands the scope of the Medicaid program and increases the number of individuals the States must cover. For example, the Act requires state programs to provide Medicaid coverage by 2014 to adults with incomes up to 133 percent of the federal poverty level, whereas many States now cover adults with children only if their income is considerably lower, and do not cover childless adults at all. §1396a(a)(10)(A)(i)(VIII). The Act increases federal funding to cover the States‘ costs in expanding Medicaid coverage. §1396d(y)(1). But if a State does not comply with the Act‘s new coverage requirements, it may lose not only the federal funding for those requirements, but all of its federal Medicaid funds. §1396c.

Twenty-six States, several individuals, and the National Federation of Independent Business brought suit in Federal District Court, challenging the consti-tutionality of the individual mandate and the Medicaid expansion. The Court of Appeals for the Eleventh Circuit upheld the Medicaid expansion as a valid exercise of Congress‘s spending power, but concluded that Congress lacked authority to enact the individual mandate. Finding the mandate severable from the Act‘s other provisions, the Eleventh Circuit left the rest of the Act intact.

Held: The judgment is affirmed in part and re-versed in part.
648 F. 3d 1235, affirmed in part and reversed in part.

[…]

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One Response to “SCOTUS DECISION – US Supreme Court Rules on Healthcare Act”

  1. Sharon says:

    This is great news. Although the individual mandate is concerning it can and should be tweaked to ensure that insurance companies are highly regulated. The elephant in the room that no one is talking about is the impact to big pharma. I opine that insurance companies have known for a while that pharma poisons with impunity and then health insurance companies pay the price by having to pay for the medical bills of those poisoned. This paradigm has changed. Health insurance companies can deny reimbursement for treatments that lack efficacy and this may be a shocker but harmful treatments and drugs and toxic scans lack efficacy. The insurance companies have been incentivized to keep us healthy and if vaccinations are causing more harm than good they know about it. If CT scans, X-rays and MRIs are causing more harm than good, they know about it. If surgical mesh is causing lifelong damage they know about it. This is a good day for patient safety. No individual could stop the large pharmaceutical companies but health insurers with this new power may be able to reel them in.

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