On Thursday, June 28th the United State Supreme Court rules in a 5-4 decision that the Affordable Act was constitutional. The deciding vote was cast by Chief Justice John Roberts. The two distinctions were made by the Court in their ruling:
- Medicaid expansion eligibility was ruled Constitutional, however the federal government cannot withhold existing Medicaid funding for states that decide not the comply (states could raise the eligibility standards to 133 percent of the federal poverty level in 2014 and not lose their federal funding);
- The individual mandate was allowed under Congress’ taxing authority.
“Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care and requiring that state accepting such funds comply with the conditions on their use,” Roberts wrote. “What Congress is not free to do is penalize states that choose not to participate in that new program by taking away their existing Medicaid funding.”
The ruling with regards to Medicaid in essence makes it optional for states and guts what President Obama envisioned, which was healthcare for everyone.
For Virginia the estimated cost of expanding the Medicaid programs is $2.2 billion over 10 years starting in 2014. If Virginia opts to expand their program, they will receive 100 percent of the cost for the newly elgibilbe, but that rate will gradually decrease to 90 percent in 2020.
Many questions remain unanswered and many scenarios are being played out among health care providers and the like. Stay tuned as this story continues to unfold…