While I’m a little shocked and disappointed today at the decision on the Affordable Care Act, I have to support Justice Roberts reasoning. “The Federal government does not have the right to compel someone to purchase health insurance. The Federal government does have the constitutional right to tax someone who does not have health insurance”
So really – the mandate was struck down – but the unfettered right to tax was upheld. The government has a right to target a category of citizens – those who do not have health insurance – and tax them.
So that’s our new starting point. Obamacare is a tax bill with lots of other good healthcare stuff.
But what of the Medicaid issue? The bill promised to add 17 million Americans to the ranks of Medicaid who previously had no health insurance. In fact – this was pretty much the main goal. The ruling on this provision has the potential of gutting the entire law. SCOTUS ruled that the federal government cannot compel states to add additional people to Medicaid by threatening to pull all Medicaid funding if they do not comply.
From Justice Roberts. “Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.”
This means that state’s are under no obligation to add these 17M people to Medicaid. Since ACA provisions provide funding for this for 5 years, why would a Governor sign up to put hundreds of thousand of people into Medicaid knowing that he/she only had 5 years of funding? After that – the state would be totally responsible for funding this Medicaid expansion.
I know 26 states who will be refusing to implement a key provision of ACA with no fear of penalty.
What will happen when these 17M people realize they are not guaranteed healthcare under this act?
I don’t think this has sunk in yet…..
Guest Blogger Jeff