In a major victory for people with disabilities and their families, the United States Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). In brief, the Court ruled that the penalties an individual would pay for not buying health insurance (referred to as the individual mandate) are constitutional under the Congress’s power to tax. This decision means that the critical health insurance reform provisions eliminating discriminatory practices such as pre-existing condition clauses, the practice of charging significantly higher premiums because of a person’s medical condition, and other practices will either remain in effect or be allowed to take effect as scheduled in 2014.
The Supreme Court also ruled that states can opt out of the health care law’s Medicaid expansion without losing federal funding for its entire Medicaid program. The Arc is concerned that disallowing the federal government’s ability to withhold Medicaid dollars from states that do not expand Medicaid to cover more of the uninsured might mean that people with I/DD who would have benefitted from the expansion could be left behind. Medicaid is an incredibly important lifeline for people with I/DD, providing health care and long term services and supports. State advocates will need to make the case that the federal government paying 100% for the first 2 years and phasing down to 90% in 2020 is a good deal for states. The Medicaid decision does not affect any of the other improvements to Medicaid’s long term services policies that were passed as a part of the ACA.
The Arc will prepare an updated explanation/discussion of the provisions of the Affordable Care Act that will benefit people with disabilities, including expected effective dates. We will continue to work on implementation issues as the Administration issues proposed regulations to implement various provisions of the law. To view The Arc’s statement visit our blog.