A narrowly divided Supreme Court upheld President Obama’s Affordable Care Act in an historic 5-4 decision.
When the decision came down Thursday morning, Dr. George Shannon, a family physician in Columbus, was with a patient:
“I just saw a 26 year old who has health insurance because of the extension of health coverage under their parent’s insurance plan, this person is looking for a job but couldn’t get it.”
Dr. Shannon’s patient and the other 123,000 young Georgians who gained health insurance under their parent’s plans due to the law will now be able to keep it.
The decision also leaves in place the so-called individual mandate. It requires Georgia’s nearly 2 million uninsured residents to buy health insurance or pay a penalty to the IRS.
Chief Justice John Roberts argued that the mandate is constitutional because the penalty functions like a tax, which Congress can regulate.
But some people might find it’s cheaper to pay the tax than to purchase health insurance, says Kelly McCutchen, with the Georgia Public Policy Foundation. He says if enough people opt out of insurance, costs could go up for people who buy it:
“So that means it will not get more people covered, and that is going to cause a huge surge in prices, as the people who are sicker are in the insurance pool and the healthier people drop out.”
Another piece of the Supreme Court’s ruling involves Medicaid. The court gave states the option to choose not to expand Medicaid eligibility without losing all federal funding, as the law had originally threatened.
Georgia will also have to make a decision about healthcare exchanges, which are like a competitive marketplace meant to create affordable insurance options. Cindy Gillespie, a healthcare policy expert with McKenna Long & Aldridge, says here Georgia has three options:
“Georgia will have to make a decision by Nov 16th whether there will be a state-based exchange established by the state or whether they want to do a partnership exchange with the federal government running the exchange and in primary control of the exchange or if they want the federal government to run the exchange in the state.”
The exchanges have a particular impact on small businesses. Under the new law, Georgia businesses with more than 50 full-time employees will have to provide coverage or face hefty fines.
But Kyle Jackson with The National Federation of Independent Business says the exchanges aren’t guaranteed to control healthcare costs:
“In some instances, health insurance inside an exchange was more expensive because you had to pay for the operation of the exchange, we think it’s worthwhile, but I don’t think we should look at exchanges as a silver bullet or a panacea for addressing cost.”
The presidential election is just 10 days earlier than the deadline to implement an exchange. So, instead of moving forward now on putting one into place, Governor Nathan Deal says Georgia will wait to see who’s elected:
“We can then make a judgment call if there is significant legislative action to repeal or modify significantly this legislation that has been approved by the court.”
For now, the Patient Protection and Affordable Care Act is the law of the land. But despite this historic ruling to keep it in place, Congress does still have the power to repeal it.