U.S. Supreme Court Upholds ACA, Medicaid Expansion, Says Individual Mandate is a Tax

In a 5-4 decision, the U.S. Supreme Court yesterday upheld the Affordable Care Act (ACA) and the "individual mandate" requiring Americans to buy health insurance or pay a penalty. The court ruled that the mandate is unconstitutional, but it can stay as part of Congress's power under a taxing clause. The court said that the government will be allowed to tax people for not having health insurance. With the ACA upheld, there will be no changes in planning for parts of the law that have gone into effect, or for the implementation of further provisions going forward. On Medicaid, the expansion of Medicaid under the Affordable Care Act was upheld, but with limitations. A majority of the court held that expanding the number of people who qualify for Medicaid is constitutional, but it would be unconstitutional to withhold Medicaid funds from states that do not implement the expansion. The expanded Medicaid program changes eligibility so that those under 65 would generally qualify if their income was less than 133% of the federal poverty level. But the Supreme Court ruling now gives states the option to opt out of the expansion; it remains to be seen how Ohio will proceed under the Kasich administration.

Republicans in Congress have pledged to repeal the full ACA, and House Republicans have scheduled a vote for July 11. Please watch OHCA and AHCA communications for more details as they become available. AHCA's statement on the ruling and more information is available at AHCA/ACA. With the Supreme Court decision upholding the ACA, providers may want to review their responsibilities as employers. AHCA has developed a PowerPoint presentation on Implementing Health Care Reform in the Workplace; you may also want to browse AHCA's Health Care Reform Resource Center which includes analysis, policy papers and other guidance.