The highest court in the country has spoken; The Affordable Care Act will continue as we know it.

by | Jun 29, 2012 | Health Care Reform, Patient Protection and Affordable Care Act | 0 comments

The United States Supreme Court ruling yesterday was complex to say the least.

Chief Justice Roberts wrote the majority opinion:

The ‘individual mandate’ was not deemed a tax under the Anti-Injunction Act; therefore, it could be ruled on by the court.

The following segment may require a law degree to interpret correctly.

Chief Justice Roberts in the majority opinion concerning the ‘ individual mandate’ wrote:

“It is of course true that the Act describes the payment as a “penalty,” not a “tax.” But while that label is fatal to the application of the Anti-Injunction Act, supra, at 12–13, it does not determine whether the payment may be viewed as an exercise of Congress’s taxing power. It is up to Congress whether to apply the Anti-Injunction Act to any particular statute, so it makes sense to be guided by Congress’s choice of label on that question. That choice does not, however, control whether an exaction is within Congress’s constitutional power to tax. “


“… the shared responsibility payment merely imposes a tax citizens may lawfully choose to pay in lieu of buying health insurance.”

Therefore, it is not a tax for the AIA but the ‘individual mandate’ is upheld under Congress’s power to tax.

The ‘medicaid expansion’ sanction was struck down as being coercive to the states. The USSC remedy for this is ‘to preclude the Federal Government from imposing such a sanction.’ But as a voluntary program Justice Ginsburg, joined by Justice Sotomayor wrote:

“Congress’ extension of Medicaid remains available to any State that affirms its willingness to participate.”

Where do we go from here?

We will continue in the same direction that we have been going since the law was signed into effect in 2010. Northeast Delta Dental has been planning for this ruling — that by the year 2014 individuals and employees of small businesses will have new opportunities to shop for dental benefits on state and federally-facilitated exchanges.

The most prominent challenge for Northeast Delta Dental will be to ensure that stand-alone dental plans are separately offered and priced to individuals and small employers both inside and outside the state and federally facilitated Exchanges in Maine, New Hampshire and Vermont.

We will have to wait until the November elections to find out exactly how the ACA will look in the future. In the interim, we will continue to be guided by clarifications from the Regulators, both federally and in our three states (ME, NH, VT). Northeast Delta Dental remains committed to its oral health mission as the ACA implementation moves forward.

If President Obama is re-elected with the Congress unchanged, then through the HHS the ACA will continue in the same direction.

If Governor Romney is elected he may chip away at the ACA through the executive branch and try to repeal the law. The extent will depend on the makeup of the Congress.

I cannot tell you who is going to win the World Series in the fall, but it will be an interesting political season. And I will do what I do best, which is to lead a strong regional prepaid dental benefits organization. Northeast Delta Dental urges exchange developers to protect consumers’ rights to keep their own dentist, keep their current dental coverage and to comparatively shop for all of their dental benefit options.

Tom Raffio
June 2012

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