The Medicaid expansion would have offered health insurance coverage to 16 million people. Now states apparently can make up their own minds whether or not to accept the expansion – and that means if Florida, Texas and other big states knock it back, then there will be millions of Americans who will miss out on the benefits of the healthcare reforms.
On the Medicaid expansion: the court has ruled that the government can only offer a carrot in terms of higher funding, but not the stick of taking away all of a state’s Medicaid funding.
States have complained that the expansion costs them money, despite the extra funding they’ll receive. Now they can turn down the expansion, which offers the expansion of coverage to mainly low income people without health insurance.
We’ll need to see some analysis of the consequences of this decision, and which states may decide to snub their noses at the Medicaid expansion.
- one The court was not swayed by arguments suggesting that the decision get delayed — an argument put forth with a 19th-century law, the Anti-Injunction Act, which blocks preemptive injunctions against taxes.
- two Justices didn’t see the penalty for ignoring the individual mandate in the Affordable Care Act as a “tax”: ”It’s up to Congress, and they did not use the word ‘tax’,” said moderate Justice Stephen G. Breyer.
- three Eight of the nine justices seemed eager to talk about the case, at times talking over each other to get a word in. The one guy who didn’t? That’s right, Clarence Thomas, who (as always) kept quiet. source
» So what’s next, anyway? With a question over whether the Supreme Court would decide before the law fully took effect largely off the table, the court will next look into the details of the law. The case, brought by 26 states and small business groups, is highly-anticipated, with many protesters outside the court on Monday. The court will likely make its decision by June, just in time to throw a wrench in the election.
So Romneycare is working. Across the board. But perhaps, as Romney implies, there’s something that makes it unsuitable for the rest of the nation.
If that’s so, however, we’re not seeing it yet. Romneycare’s cousin, the Affordable Care Act — or, as it’s more frequently known, Obamacare — isn’t fully in place, and won’t be until 2014 at the earliest. But it has passed. And since it has passed, health-care spending has been dropping. Karen Davis, director of the Commonwealth Fund, writes that the most recent spending projections show a “$275 billion (5.6 percent) reduction for 2020, compared with pre-reform estimates. Moreover, that projection represents a cumulative reduction of $1.7 trillion over the 10 years from 2011 to 2020.”
You might argue that that’s just the recession, but as Davis writes, “the recession doesn’t plausibly explain why projected health spending in 2020 is substantially below estimates made just two years ago.” And why the recession having such an effect on long-term spending under Medicare? The latest data shows we’re on track to spend $750 billion less than the pre-reform projections suggested. The Medicare cuts in the Affordable Care Act account for barely half of that. If these trends hold, the Affordable Care Act will cost far less than anticipated.
- 54 million people benefited from the Affordable Care Act in 2011 source
» Approximately one-sixth of Americans received one or more additional preventive care services in 2011, as a direct result of the Affordable Care Act, according to a newly released report from the U.S. Department of Health & Human Services. Over 20 million adult women received an additional service, as well as 14 million children, and just under 20 million adult men. Of the 50 states, Wyoming had the fewest patients (102,000) receive a new service while California took the cake with more than 6 million patients, over 2 million more than 2nd place Texas, receiving at least one new preventive service last year.