Yesterday, the Supreme Court of the United States issued its ruling on the constitutionality of the Patient Protection and Affordable Care Act (ACA). By a vote of 5 to 4, the Court ruled that the law is constitutional. Chief Justice Roberts (considered a conservative) joined the four liberal justices to uphold the law. A copy of the decision is available here.
You may wonder what this really means, and how will it affect meso patients. In a nutshell, here is what happened…
The decision of the Supreme Court upheld the individual mandate provision, which requires American citizens to be insured or subject to a penalty tax. This means that the majority of citizens must either hold private health insurance, be covered under an employer-based health plan or be enrolled in a public plan such as Medicare or Medicaid. Those who are not covered under one of these programs will be subject to a tax. Whether and how this tax would be enforced is unclear, though the court was clear that it would be considered a tax like any other.
The Medicaid provision in the law that requires states to comply with the expansion of Medicaid or lose all of their Medicaid funding was struck down.[i] Medicaid is traditionally a Federal/State partnership, in which the Federal and State governments share the cost of the program. Under the legislation, the Federal Government would mandate the states to participate, initially cover the cost, with the states later being required to pay one tenth of the costs. As the law is written, states must participate in the Medicaid expansion or risk losing all of their Federal Medicaid funding, however, the ruling of the Supreme Court basically made the participation of the states optional. There is concern that some states will choose not to expand Medicaid coverage, denying many vulnerable citizens access to the coverage they need.
There are several other provisions that are beneficial to mesothelioma patients included in the Affordable Care Act:
- The ACA eliminates the ability of insurers to discontinue coverage for people who receive dire diagnoses
- The ACA eliminates discrimination based on pre-existing medical conditions
- The ACA eliminates annual and lifetime insurance caps
- The ACA requires insurers to provide consumers with easy-to-understand summaries about their coverage
- The ACA requires health plans in the individual market to offer essential benefits needed to prevent and treat a serious condition such as mesothelioma
- The ACA requires states to create online Health Exchanges that give individuals access to compare health insurance plans and choose what is best for their family
These provisions will not be immediately implemented, but some begin as early as 2014.
If you have any further questions, please feel free to contact Jessica Barker: [email protected] or 703.879.3819
