Supreme Court Review of the Health Care Reform Law (New Eng Jour Med)

Supreme Court Review of the Health Care Reform Law

Gregory D. Curfman, M.D., Brendan S. Abel, B.A., and Renée M. Landers, J.D.
March 15, 2012

Later this month, the U.S. Supreme Court will examine the constitutionality of the Affordable Care Act (ACA),1 potentially producing a landmark decision. For most cases, the Supreme Court allocates 1 hour for oral argument — 30 minutes for each side. For the health care reform case, the Court has scheduled 6 hours for oral argument — the most time devoted to a case in more than 45 years. These arguments will take place on March 26, 27, and 28, and the Court's ruling will probably be announced in June.

Setting the foundation for the largest expansion of health care coverage since Medicare was established in 1965, the ACA will reach approximately 32 million of the 50 million Americans who are now uninsured. It will do so in two ways.

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First, beginning in 2014, the ACA's “individual mandate” requires most citizens and legal residents whose income is above the threshold for filing federal income taxes to maintain health insurance or pay a financial penalty — with exemptions for those who cannot afford coverage, have incomes below 100% of the federal poverty level, or lacked coverage for less than 3 months of the year. Individuals with incomes between 100% and 400% of the poverty level will qualify for income-based federal subsidies. The individual mandate, when fully implemented in 2016, is expected to add 16 million people to the rolls of the insured.

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Second, the ACA extends Medicaid eligibility to all citizens and certain legal residents with incomes of up to 133% of the poverty level, making an additional 16 million people eligible for the federal–state program. States not complying with the expansion risk losing all federal Medicaid funds. The federal government will pay 100% of Medicaid coverage for the newly eligible for the first 2 years and gradually reduce its contribution to 90% in 2020.

more of a good read at - http://www.nejm.org/doi/full/10.1056/NEJMp1114933?query=TOC

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