The Latest: During June, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act (ACA):
The penalty provisions for individuals who do not purchase health insurance were found by the court to be within the federal government’s taxing power.
The federal government can offer states additional funds under the ACA to expand the availability of health care under Medicaid, and require that states accepting such funds comply with the conditions on their use, but the court ruled that the federal government is not free to penalize states that choose not to participate in the Medicaid expansion by taking away their existing Medicaid funding.
As a result of the ruling, there have been questions raised by states regarding Medicaid expansion and establishment of state health insurance exchanges:
Pennsylvania Implications: There are implications for Pennsylvania given the ruling:
Pennsylvania will need to implement the health insurance exchange and consider whether to implement the Medicaid expansion as required by the ACA by 2014. The interrelationship of these two issues on the state’s uninsured population will need to be considered.
Uncompensated care at hospitals has continued to increase, with the Pennsylvania Health Care Cost Containment Council reporting that, during fiscal year 2011, uncompensated care at the state’s acute care hospitals had reached $990 million.
The Medicare and Medicaid hospital payment reductions and policy changes will proceed and are anticipated to reduce payments to Pennsylvania hospitals by $7 billion over a ten-year period.
The Pre-Existing Condition Insurance Plan (PCIP)program helps people who have been locked out of the individual insurance market because of their health. The PCIP is a bridge program—only available until 2014—when new insurance rules go in to effect. A number of resources are available to promote the program: