The Supreme Court Health Care Decision: What It Means to You

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If you thought healthcare reform was complicated when it passed Congress in 2010, you were really confused this morning…

  • “Mandate struck down,” CNN declared a few minutes after 10 a.m., when the Supreme Court ruled on a challenge to the Patient Protection and Affordable Care Act (ACA).
  • “Supreme Court Allows Health Care Law to Largely Stand,” The New York Times reported a few minutes later.
  • “Supreme Court rules individual health care mandate may be upheld under congressional tax authority,” MSNBC added a few minutes after that.

So what really happened? And what does it mean for your insurance policy and your pocketbook?

Here’s a short video I put together that will help you understand what’s happening. Check it out, then read on for more.

Bottom line: All the ACA’s provisions will stay – even the individual mandate. (Read the Supreme Court’s decision.)

The ACA phased in a lot of changes to the way we all get health insurance. But the Big One was that it required almost every American to get coverage by 2014 – or pay a fine. That was called “the individual mandate,” and that’s what many pundits predicted would get struck down this morning.

Those experts thought the Supreme Court would rule it’s unconstitutional to force you to buy health insurance. But those experts were wrong – by a single vote. The justices voted 5-4 to to uphold the individual mandate by saying the penalty for not buying insurance is like a tax – which the government has a right to do. MSNBC called it “a dramatic victory for President Barack Obama.”

Lost in the tussle over the mandate, and the political maneuvering among Republicans and Democrats, is that many other ACA provisions also remain…

  1. No more caps on coverage. The insurance companies can no longer cap your coverage, either annually or over your lifetime – a big deal should you ever develop an illness that requires big bucks to address. Prior to this reform, insurance companies routinely employed “lifetime caps” of 1 to 3 million dollars. Which means if you spent more than that over your lifetime, you’d lose your coverage and be forced to pay every bill yourself, a virtual guarantee that you’d be bankrupt shortly thereafter.
  2. No more getting turned down for coverage based on pre-existing medical conditions. Starting in 2014, if you have an illness like cancer or diabetes, insurance companies can no longer refuse to insure you – or turn you away by charging so much in premiums that there’s no way you can afford to pay. Children are an exception: Children already can’t be turned down because of pre-existing conditions.
  3. No more booting kids off parents’ policies at 21. Dependent children up to 26 years old can remain covered under their parents’ policy. Keeping kids on a parental policy is normally cheaper than insuring kids individually.
  4. Payments for preventive health care. Until health care reform, preventive care coverage – like annual physicals, for example – could be subject to deductibles and co-pays. Now it’s free: no co-pay, no out of pocket (although there’s still some doubt this is actually happening).
  5. State insurance marketplaces: Starting in 2014, states will operate insurance marketplaces that are designed to lower prices by increasing competition. Those who pay for their own insurance, like the many self-employed Americans, should find lower-priced plans thanks to the increased competition afforded by these marketplaces.
  6. Coverage for low-income Americans: The law expanded Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% of the federal poverty level.

The fight over the ACA isn’t over. It now moves from the courts to the political arena. “The debate over health care remains far from over, with Republicans vowing to carry on their fight against the law,” The New York Times reported this morning. “The presumptive Republican presidential nominee, Mitt Romney, has promised to undo it if elected.”

Bottom line? It will almost certainly be months before the dust settles and we begin feeling the impact of today’s decision. About the only thing we know for sure is there will be an impact on your family’s finances – millions more Americans will be participating the healthcare system going forward. And those that do will find more complete coverages, hopefully at lower prices.

As we get more information, we’ll certainly pass it along. But in the meantime, what are your thoughts about what’s happening to health care in the this country? Do you agree with today’s decision? Tell us what you think below or on our Facebook page.

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