Originally Published at Nieman Watchdog, in ASK THIS, June 14, 2012, health care expert Judith Stein, director of the Center for Medicare Advocacy, offers a guide to review the Supreme Court's ruling in the Affordable Care Act case. We suggest the following key questions to help understand the decision:
1. Did the Court strike down (or uphold) the entire law?
2. If the entire law is struck down:
- What will happen to the Medicare Part D Donut Hole coverage, preventive benefit coverage improvements, Part D income-based premiums?
- Will young adults receiving coverage up to age 26 on their parents' plans immediately lose their coverage? Will they be able to get coverage elsewhere?
- Will children with pre-existing conditions lose their coverage? If so, how will they get coverage in the future?
- What will happen in states that have started to implement the law, for example by setting up “exchanges”? Will some states try to proceed without ACA?
- What will happen to those who would have been covered by the Medicaid enhancements under the law?
3. Did the Court decide some components are “severable,” (able to proceed although other components of the law are invalid)?
- If so, what was struck down?
- What is left?
4. If the individual mandate is struck down (the requirement that people maintain minimum coverage or pay into the system), what does that mean for health care reform?
- Can the law still work without this requirement?
- Can the law be amended to make it work, without a minimum coverage mandate?
5. If the law is struck down in whole or part:
- What demographic groups will be most harmed?
- What will be the effect on costs to the federal government, states, and individuals?