Image of activists in front of the Supreme Court on the first day of “Obamacare” hearings on March 26, 2012, by OlegAlbinsky/iStockphoto
“Obamacare” (Mostly) Upheld by Supreme Court
The sweeping health care reforms passed in the 2010 Patient Protection and Affordable Care Act (ACA) represented the largest systemic changes to the U.S. national health care system in nearly a half century. Intact, the law would extend access to affordable health care to 32 million otherwise uninsured Americans, helping more people obtain consistent and preventive care. Encouraging health care information technologies and integrated systems, such as electronic health records, will likely reduce medical errors and provide reams of new data for medical research. Additionally, the law contains provisions to boost comparative- and cost-effectiveness research (via the newly established Patient-Centered Outcomes Research Institute). Such research could lead to medical and public health advances that will help the largest number of people. In addition to improving health in the U.S., all of these changes should help reign in runaway health care costs, which topped $2.6 trillion in 2010 and are projected to keep climbing.
But all of that hard-won reform was up for major revision—or full repeal—as the U.S. Supreme Court heard arguments about the case in March 2012. The Court's decision, announced on June 28, upheld most of the ACA.
The only provision that the Court undercut was the mandatory expansion of state-run Medicaid programs. Under the original ACA, Medicaid eligibility was to be expanded to include 16 million more people nationwide who would otherwise have trouble paying for health insurance. The federal government would foot the whole bill for states until 2016, then gradually step back to paying 90 percent in 2022 and beyond. So far at least nine states have said they will forgo the expansion, citing a reluctance to spend more of their own pinched pennies.
With Pres. Barack Obama's reelection in November, the law looks likely to continue rolling out the rest of its provisions through 2020. Starting in 2014, for example, insurers will no longer be allowed to make coverage or rate decisions based on a person's preexisting conditions; state or federally controlled insurance exchanges will have to be operational; and Medicare eligibility expansions—in participating states—will take effect.—Katherine Harmon
» Health Care Reform on Trial: What's at Stake in the Supreme Court Arguments
» Health Act Intact: U.S. Supreme Court Upholds Affordable Care
» Could Medicaid Benefits Get Pushed off the Fiscal Cliff?
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