What's at stake in the much-anticipated high court health law decision?

Jun 21 2012

News outlets report on how the ruling will impact seniors, women and states, among other stakeholders. Reports also examine what might happen if the individual mandate is overturned but other elements of the law are left intact.

Reuters/Chicago Tribune: Health Benefits Americans Could Lose In Court Ruling
The U.S. Supreme Court is expected to issue a ruling by the end of this month on the fate of President Barack Obama's healthcare law. Following are some of the provisions already in effect under the law that Americans would lose immediately if it were to be overturned. Other provisions not listed below would come into force in 2014 if the court were to leave the law in effect (6/19).

Los Angeles Times: California To Lose Big If Supreme Court Scraps U.S. Healthcare Law
If the Supreme Court scraps the Affordable Care Act in the coming days, California will lose out on as much as $15 billion annually in new federal money slated to come its way, dealing what state officials say would be a critical blow to efforts to expand coverage to the poor and uninsured. The state is one of the biggest beneficiaries of the federal healthcare law because of its large number of uninsured residents -; about 7 million people, or nearly 20% of California's population (Terhune, Gorman and Loury, 6/20).

HealthyCal.org:  Millions Will Remain Uninsured After Health Care Reform
Up to 10 percent of California's 40 million residents will not have health insurance after national health care reform begins in 2014, according to new numbers released from University of California, Berkeley last week.  Those numbers, health officials say, run contrary to the popular belief that nearly everyone will be covered by insurance in two years. That's when the Affordable Care Act, passed into federal law in 2010, takes full effect. As a result, doctors and clinics that traditionally provide care to the uninsured are working to make sure the money to treat those patients does not disappear (Bookwalter, 6/20).

Baltimore Sun: Supreme Court Decision On Health Care Reform Law May Mean Changes In Maryland
Initial projections show about 180,000 people in Maryland would gain insurance through the exchange and 84,000 through Medicaid's expansion in the first year, according to the Governor's Office of Health Reform. The exchange and Medicaid expansion could move ahead without the subsidies but other funding would be needed, [Lt. Gov. Anthony] Brown said. More than $400 million in federal subsidies was expected just for those on the exchange, according to the Hilltop Institute at the University of Maryland, Baltimore County, a nonpartisan health research organization. It's "probable" Maryland's exchange would operate without the law, Brown said, but there would be a lot of review and debate. Requiring the public to buy insurance in Maryland might be a tougher sell but "would be part of the conversation," he said (Cohn and Walker, 6/19).

Kaiser Health News: What's At Stake For Women If SCOTUS Overturns The Health Law
A provision in the 2010 health care law requiring contraceptive coverage for women without copays has gotten most of the press. But much more is at stake for women if the Supreme Court overturns the health care law. Starting in 2014, the law bars insurance practices such as charging women higher premiums than men, or denying coverage for pre-existing conditions that could include pregnancy, a Caesarean-section birth or a sexual or a domestic violence assault (Appleby, 6/19).

Kaiser Health News: What's At Stake For Medicare Beneficiaries In Supreme Court Decision
On average, seniors and disabled people covered by Medicare saved $604 in 2011 on prescription drugs, and more than 26 million saw their doctors for wellness visits or got preventive services. If the court strikes down only the law's individual mandate, which requires most people to buy insurance, nearly all of the health law's Medicare changes will remain intact (Werber Serafini, 6/19). 

Kaiser Health News: Some Health System Changes Will Stay, No Matter How SCOTUS Rules
Now the Affordable Care Act is in jeopardy, but many of the reforms it encouraged aren't, Wilson says. Soaring costs, tight budgets, better technology and industry consolidation ensure health care won't go back to 2009 no matter what the court or Congress do, say analysts and industry officials (Hancock, 6/19). 

The Hill: House Dem: Ruling Striking Mandate Won't Be A 'Show-Stopper' For Health Law
A leading House Democrat said Tuesday that if the Supreme Court strikes down the individual mandate, it will not be "a show-stopper" for the healthcare law. Rep. Jan Schakowsky (Ill.), the chief deputy whip for House Democrats, predicted during an interview on The Bill Press Show that the entire law would be upheld but said her party "would absolutely move forward" with the remaining reforms even if the mandate is defeated. "There are other ways to skin the cat -; to make sure that people do join and get insurance," she added. "So I don't think [a ruling against the mandate] would be a complete show-stopper" (Viebeck, 6/19).

The New York Times' Economic Scene: Self-Interest Meets Mandate
Odds that the justices will reject this measure, the so-called individual mandate, are approaching 80 percent on Intrade, a market where investors can bet on the outcome of pretty much everything. What's harder to figure out is what will then happen to health insurance. Advocates of health care reform argue that eliminating the mandate could gut the president's plan. Most health economists would probably agree. But this consensus is based on a fairly optimistic view that the individual mandate and accompanying fines for failing to comply will be highly effective at persuading Americans to buy health insurance that they would otherwise forgo (Porter, 6/19).

CQ HealthBeat: End Of Mandate Wouldn't Mean Certain 'Death Spiral,' Analysts Say
It's not true that premiums inevitably would zoom out of sight in the individual insurance market if the Supreme Court strikes down the individual mandate in the health care law. So say two Kaiser Family Foundation analysts, contradicting widespread predictions that such a "death spiral" would occur. "It is by no means inevitable that the individual insurance market will enter a spiral of death," Larry Levitt and Gary Claxton said in a blog post Tuesday. "In fact, there are some good reasons to believe that may not happen" (Reichard, 6/19).