Health Care Law Analysis

The U.S. Supreme Court's ruling on the controversial Affordable Care Act is expected in the next two weeks. A noted law professor and a health care specialist join us on Chicago Tonight at 7:00 pm with their thoughts on how the justices may rule, and the implications of the decision. Check out Pros and Cons of the Affordable Care Act, and visit the PDF below to read the full text.

PROS:

- As of August 1, 2012, insurance plans must cover preventive services such as contraceptives, cervical cancer screenings and immunizations for children

- Pre-Existing Condition Insurance Plan (PCIP) provides health care coverage to U.S. citizens and legal residents who have been denied health care coverage and have been uninsured for at least 6 months

- Consumers and small business owners can buy insurance from co-ops made by the consumers

- Board of Directors elected by the consumers

- Begins January 2014

- Limits how many consumer premium dollars can be spent on non-health care related expenses (administrative costs etc)

- Lifetimes dollar limits are prohibited as of 2010*

- By 2014, annual dollar limits will be phased out entirely

- As of September 2011, companies must justify any 10 percent or higher rate increase before the increase takes effect

- There’s a tax credit available to employers with fewer than 25 employees

- Credit up to 35% (25% for non-profits)

- 2014 will increase to 50% (35% non-profits)

- Consumers can compare health insurance coverage options at healthcare.gov

- To increase availability to Primary Care, there’s now a Prevention and Public Health Fund to boost the supply of primary care providers and new resources

- Tax benefits for professionals in underserved areas

- Increase in Pell Grants

- Loan forgiveness programs for students in health care education programs

CONS:
For Consumers:

- Job-based plans and Grandfathered plans are not required to provide certain recommended preventive services at no additional cost

- Grandfathered individual plans are exempt from phasing out annual dollar limits on key benefits

- Individual grandfathered plans also don’t have to eliminate pre-existing condition exclusions for children under the age of 19

- The individual mandate requires that individuals either purchase health insurance or that they be included in some kind of health care plan

- There’s also the issue of constitutionality, detractors of the health care plan say that the individual mandate is unconstitutional

For Employers:

- Some employers fear that provisions in the bill will raise costs of providing health insurance to employees

Unconstitutionality

- Congress cites the commerce clause, the tax clause, and the “necessary and proper” clause as the bases of the constitutionality of the Affordable Care Act. Federal Judges in Atlanta’s 11th Circuit U.S. Court of Appeals however say that the law is unconstitutional because there is no judicial precedent for the scope of the act.

- “What the Court has never done is interpret the Commerce Clause to allow Congress to dictate the financial decisions of Americans through an economic mandate.”

- Congress has never required individuals to purchase a good as a condition of lawful residence in the U.S.

- Mandates typically apply to people as parties to economic transactions, not as members of society

- General opponents also say that the scope of the law is so wide, that granting Congress the power to mandate health insurance gives them an unrestricted amount of power over individuals’ lives

- Congress says that buying or choosing not to buy health insurance is an economic decision, but under that logic detractors say that many individual choices would be seen as economic decisions that could be regulated by Congress

*indicates that this service may not be covered for job-based insurance plans or under grandfathered insurance plans

- Written by Wellesley Fellow Danielle Marburgh

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