This post was written by Katie Keith, Assistant Research Professor, Georgetown University Health Policy Institute Center on Health Insurance Reforms. Any questions or comments about this post can be directed to kmk82@georgetown.edu.
On June 28, 2012, the Supreme Court of the United States largely upheld landmark health reform legislation known as the Patient Protection and Affordable Care Act of 2010 (ACA). By ushering in significant changes to the regulation of private health insurance and Medicaid as well as creating new incentives in Medicare and funding for public health programs, the ACA has the potential to transform the accessibility, adequacy, and affordability of health coverage and health care in the United States.
Yet, because many of the ACA’s comprehensive reforms do not go into effect until 2014, states and the federal government have much to do to prepare for the significant regulatory changes to come. Here, I discuss the potential implications of the Supreme Court’s ruling on state and federal efforts to implement the ACA.
What Did the Supreme Court Rule?
With the exception of one provision, five justices—Roberts, Breyer, Ginsburg, Sotomayor, and Kagan—held that the entire ACA was constitutional. Writing for the majority, Chief Justice John Roberts held that the law’s most controversial provision, the individual mandate, was constitutional under Congress’ authority to tax and spend.
In upholding the mandate as a tax, Chief Justice Roberts concluded that 1) the Anti-Injunction Act did not bar the Supreme Court from considering the constitutionality of the mandate; 2) the mandate could not be sustained under Congress’ power to regulate interstate commerce; and 3) the mandate could not be upheld pursuant to Congress’ authority to enact laws that are “necessary and proper” to its exercise of congressional authority. READ MORE »
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