Quantcast
Get breaking news alerts via email

Click here to manage your alerts
Health care countdown: Who wins, loses — pays?
Supreme Court » Whatever way the ruling turns out, problems won’t go away.


< Previous Page


Taxes, Medicare cuts and penalties on employers not offering coverage would stay in place.

Photos
Join the Discussion
Post a Comment

What if the court strikes down the mandate and also invalidates the parts of the law that require insurance companies to cover people regardless of medical problems and that limit what people can be charged?

Many fewer people would get covered, but the health insurance industry would avoid a dire financial hit.

Insurers could continue screening out people with a history of medical problems — diabetes patients or cancer survivors, for example.

That would prevent a sudden jump in premiums. But it would leave consumers with no assurance that they could get health insurance when they need it, which is a major problem the law was intended to fix.

Obama administration lawyers say the insurance requirement goes hand in hand with the coverage guarantee and cap on premiums, and they have asked the court to get rid of both if it finds the mandate to be unconstitutional.

One scenario sends shivers through the health care industry: The Supreme Court strikes down the mandate only, and delegates other courts to determine what else stays or goes.

What happens if the court throws out only the expansion of the Medicaid program?


story continues below
story continues below

That would limit the law’s impact severely because roughly half of the more than 30 million people expected to gain insurance under the law would get it through the expansion of Medicaid, the federal-state health insurance program for low-income people.

But a potentially sizable number of those low-income people still might be eligible for government-subsidized private insurance under other provisions. Private coverage is more expensive to subsidize than Medicaid.

States suing to overturn the federal law argue that the Medicaid expansion comes with so many strings attached it amounts to an unconstitutional power grab by Washington. The administration says the federal government will pay virtually all the cost and says the expansion is no different from ones that states have accepted in the past.

What happens if the court simply punts, deciding it’s too early for a constitutional challenge?

The wild card, and least conclusive outcome in the case, probably also is the least likely, based on what justices said during oral arguments.

No justice seemed inclined to take this path, which involves the court’s consideration of a technical issue.

The federal appeals court in Richmond, Va., held that the challenge to the insurance requirement has to wait until people start paying the penalty for not purchasing insurance. The appeals court said it was bound by the federal Anti-Injunction Act, which says federal courts may not hear challenges to taxes, or anything that looks like a tax, until after the taxes are paid.

So if the justices have trouble coming together on any of the other options they could simply put the whole thing off.

The administration says it doesn’t want this result. Yet such a decision would allow it to continue putting the law in place, postponing any challenge until more of the benefits are being received. On the other hand, it might give Republicans more ammunition to press for repeal in the meantime.



Copyright 2014 The Salt Lake Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Top Reader Comments Read All Comments Post a Comment
Click here to read all comments   Click here to post a comment


About Reader Comments


Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting "Flag comment as inappropriate". If you've recently registered with Disqus or aren't seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account.
See more about comments here.
Staying Connected
Videos
Jobs
Contests and Promotions
  • Search Obituaries
  • Place an Obituary

  • Search Cars
  • Search Homes
  • Search Jobs
  • Search Marketplace
  • Search Legal Notices

  • Other Services
  • Advertise With Us
  • Subscribe to the Newspaper
  • Login to the Electronic Edition
  • Frequently Asked Questions
  • Contact a newsroom staff member
  • Access the Trib Archives
  • Privacy Policy
  • Missing your paper? Need to place your paper on vacation hold? For this and any other subscription related needs, click here or call 801.204.6100.