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Healthcare Law

U.S. Supreme Court to Decide Whether Health Care Reform Law Will Stand

Earlier this week the Supreme Court got the ball rolling toward what is expected to be the final showdown on the federal health insurance reform law. The Court agreed to hear several issues that have been litigated in lower courts since the law was enacted. The Court set aside an unprecedented 5 and ½ hours for oral arguments (argument is typically limited to 60 minutes).

Politically, the Patient Protection and Affordable Care Act, passed in 2010, has been viewed as the most important piece of legislation of the Obama Administration. Politics will no doubt be in play when the Supreme Court takes up the issue in March 2012; however, the future of healthcare reimbursement is also hanging in the balance. PPACA includes wide-ranging health insurance reforms related to pre-existing conditions, rescissions of coverage, claim appeals procedures, expanded coverage for dependents, medical loss ratio mandates for insurers, expanded access to Medicaid, the creation of health insurance exchanges, and, of course, the mandates on individuals to obtain insurance and certain employers to offer insurance.

The challenges to the law began immediately. Various issues have been litigated in the lower courts, but the Supreme Court agreed to decide only certain issues:

  • Individual Mandate: Whether the mandate that individuals obtain health insurance is constitutional
  • Severability: If that mandate is not constitutional, whether the rest of the law be enforced or must the entire law fail if the individual mandate is unconstitutional
  • Anti-Injunction Act: Whether challenges to PPACA are barred by a federal law that prohibits federal courts from stopping state court proceedings
  • Medicaid Expansion: Whether the expansion of Medicaid program to poor and disabled is constitutional

Significantly, the Court declined to consider whether the mandate that certain employers provide insurance to employees is constitutional.

PPACA contains many common sense reforms that enjoy near unanimous support. While many of the more dramatic changes have not even become effective to date, many of the day-to-day provisions that impact healthcare reimbursement are already in place. If the law is unconstitutional, these popular, common-sense reforms would go away.

While there is ample room to debate the questions that will be considered by the Court, there is little debate about other provisions of PPACA.

Supreme Court followers expect that the Court will issue a ruling by next June.