Tag Archive: NFIB v. Sebelius

The states with the biggest Obamacare struggles spent years undermining the law

As insurers exit Obamacare marketplaces across the country, critics of the Affordable Care Act have redoubled claims that the health law isn’t working. Yet these same critics, many of them Republican politicians in red states, took steps over the last several years to undermine the 2010 law and fuel the current turmoil in their insurance markets. Among other things, they blocked expansion of Medicaid coverage for the poor, erected barriers to enrollment and refused to move health plans into the Obamacare marketplaces, a key step to bringing in healthier consumers.

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There are many fewer options in states whose leaders have spent years working to sabotage the law.

Source: The states with the biggest Obamacare struggles spent years undermining the law

It is inaccurate to describe red states as “sabotaging” Obamacare. The ACA is a federal-state initiative that afforded a good degree of policy latitude to the states, with that freedom vis Medicaid expansion broadened by the USSC in NFIB v. Sebelius (2012).

The real issue is there is no policy consensus among the states re health care reform notwithstanding broad agreement that reform is essential. Also, the individual market poses enormous challenges re achieving spread of risk to ensure this market segment’s long term actuarial viability. Contributing to that challenge is a culture that does not value health promoting lifestyles and regards medical care and insurance as high cost consumer commodities.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

More than a quarter of nation’s medically uninsured to remain so under ACA

The Patient Protection and Affordable Care Act is described as the most comprehensive overhaul of the U.S. health care system in the nearly 50 years since the enactment of Medicare and Medicaid to serve the elderly and poor, respectively. However as far reaching as it is, it fails to achieve its public policy goal of ensuring all Americans have access to an affordable health plan, concludes a Kaiser Family Foundation report.

The ACA and the Supreme Court’s June 2012 ruling in NFIB v. Sebelius invalidating the law’s mandate on states to expand Medicaid eligibility requirements means 5.2 million Americans residing in states that have not voluntarily opted to expand Medicaid eligibility – an estimated 27 percent of the medically uninsured – will remain without any form of public or private coverage.

The primary reason is in 22 of those 26 states, families earning less than 100 percent of the Federal Poverty Level (FPL) are under the ACA ineligible to purchase subsidized private coverage in the state health benefit exchange marketplace. But in most of those states, many families are also not eligible for Medicaid because their household income exceeds state Medicaid eligibility levels. (See Table 1 of the KFF issue brief, showing nearly all of those states cutting off Medicaid eligibility at 75 percent of FPL and most around half of FPL for a family of three). Also remaining uncovered in nearly all of those states (except Wisconsin) are low income childless adults earning less than 100 percent of FPL.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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