Tag: Individual mandate

Supreme Court hears severability oral argument

Posted by mmcdowell on March 28, 2012

On the last day of oral arguments surrounding the Affordable Care Act (ACA), the Supreme Court heard the severability issue in the morning. The severability question would only come into play if the Justices rule to strike down the minimum coverage provision (argued yesterday).

Mr. Paul Clement, representing the challengers, opened this morning’s arguments. Mr. Edwin Kneedler followed, presenting the government’s position. Mr. Kneedler argued that if the individual mandate is stricken from the ACA, two other provisions would have to fall as well. The first prohibits insurers from turning away individuals due to pre-existing conditions. The second provision limits how insurers can set rates. The government takes issue with the aforementioned provisions because if applied in the absence of the mandate, the insurance market would crater. Apart from these insurance regulations, however, the government argued that every other aspect of the law could stand in the absence of the individual mandate.

Following Mr. Kneedler’s argument was Mr. H. Bartow Farr, a court appointed lawyer, who argued that all other provisions of the law should remain in place even if the Justices strike the minimum coverage provision.

Mr. Clement returned for a four-minute rebuttal to close the morning session.

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Supreme Court hears minimum coverage provision oral argument

Posted by mmcdowell on March 27, 2012

Today, from 10:00 am-12:02 pm, the Supreme Court heard one of the most highly anticipated oral arguments in years. The subject in question was the constitutionality of the individual mandate, a provision of the March 2010 Affordable Care Act (ACA). The 26 states, the National Federation of Independent Business (NFIB), and a few individual business owners brought the suit, contending that the law’s individual mandate is unconstitutional. The challengers argued that the minimum coverage provision regulates economic “inactivity,” and forces people to enter a market. The Obama Administration, on the other hand, contended that it is essentially impossible to avoid entry into the health care market. Health insurance is not a stand-alone product, like broccoli or a car, but rather a means of financing a market.

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RWJF and Urban issue paper on the effect of the minimum coverage provision

Posted by mmcdowell on

The minimum coverage provision, or individual mandate, is a provision under the 2010 Affordable Care Act (ACA). According to a short paper recently issued by The Robert Wood Johnson Foundation and the Urban Institute, if the ACA were in effect today, 94 percent of the total population (93% of the nonelderly population) or 250.3 million people out of 268.8 million—would not face a requirement to newly purchase insurance or pay a fine.

In this brief, the authors use the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM) to estimate the number and share of Americans potentially subject to the mandate, identify their insurance status absent the ACA, and simulate eligibility for Medicaid and exchange-based premium and cost-sharing subsidies. To allow the most direct comparison of postreform coverage with coverage absent reform, their analysis treats the provisions of the ACA as if fully implemented in 2011. The results of their analysis are presented in a table format—with estimates of the population exempt from the mandate; the population potentially affected by the mandate but already covered by insurance of some type; and the remaining population required to newly purchase coverage or pay a fine.

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Supreme Court grants request for more time

Posted by mmcdowell on February 21, 2012

The Supreme Court justices announced that they would lengthen the time allotted to hear the Anti-Injunction Act issue from 60 to 90 minutes. This issue surrounds whether the justices have the authority to decide whether the Affordable Care Act’s (ACA’s) minimum coverage provision is constitutional. This will bring the case to a total of six hours, making it the longest Supreme Court case in modern history. For the Anti-Injunction Act, the court will hear from a third-party attorney for 40 minutes, the Justice Department for 30 minutes, and the NFIB and the states will get 20 minutes. Next, the justices will hear two hours regarding whether the insurance mandate is constitutional. This issue of the severability of the individual mandate from the rest of the ACA will receive two and a half hours. The court will finally spend an hour on the states’ challenges to Medicaid expansion.

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RAND Corporation releases report on ACA without individual mandate

Posted by mmcdowell on February 16, 2012

The RAND Corporation recently released a report addressing the question “How would removing the individual mandate from the Affordable Care Act (ACA) affect the number of insured individuals, premium costs for those who are insured through the exchanges, and government spending on health coverage?” RAND addressed the question by using COMPARE (Comprehensive Assessment of Reform Efforts) microsimulation model to predict the effects of a possible Supreme Court decision invalidating the individual mandate provision in the Affordable Care Act (ACA) while keeping the other parts of the law intact. The authors predict the effects of such a decision on health insurance coverage overall and for subgroups based on income. They also estimate where people will obtain insurance in scenarios with and without the mandate and how the elimination of the individual mandate will affect insurance premiums.

The analysis predicted that…

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Maintenance of Minimum Essential Coverage

Posted by mmcdowell on February 10, 2012

Approximately 49 million nonelderly Americans are uninsured. Of those, approximately 20 percent have the financial means to buy health insurance but decide not to and instead rely on emergency care when necessary; the rest desire insurance but are denied coverage or cannot afford it. Even though uninsured, some individuals in the latter group receive medical services, resulting in approximately $43 billion worth of uncompensated care costs. These costs are recouped through higher charges for health care services, thereby producing a cost-shifting effect that results in higher premiums for those who are insured. This cost shift is…

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RWJF report assesses the individual mandate in a new report

Posted by mmcdowell on January 12, 2012

Today the Robert Wood Johnson Foundation (RWJF) released a report authored by researchers from the Urban Institute called “Eliminating the Individual Mandate: Effects on Premiums, Coverage, and Uncompensated Care: Timely Analysis of Immediate Health Policy Issues.” The report examines the effect that eliminating the individual mandate—the requirement for most Americans to have health insurance or face a penalty—would have on health insurance coverage, spending, premiums and uncompensated care. Using the Urban Institute’s Health Insurance Policy Simulation Model, the researchers simulated the Affordable Care Act as enacted, as well as several alternative scenarios of health reform without the mandate.

The authors find that without the mandate:
1) Between 40 and 42 million would remain uninsured as opposed to 26 million with the mandate;
2) Private coverage would fall 11 million, covering 4 million fewer people than it would have without reform;
3) Uncompensated care spending would be much higher due to the increased number of uninsured; and
4) Individual premiums in the health benefit exchanges would increase by 10 percent in a scenario assuming high exchange participation, and by 25 percent with a low participation scenario.

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Constitutional Challenges Update: Florida et al. v United States Department of Health and Human Services

Posted by Mark Dorley on January 4, 2012

On November 14, 2011 the United States Supreme Court agreed to hear oral arguments on issues that have arisen as a result of more than two dozen legal challenges to the Affordable Care Act (ACA) that were filed upon or immediately following the March 2010 enactment of the health reform law. The Court will consider four constitutional issues related to the ACA: (1) whether Congress has the power under Article I of the Constitution to enact the coverage requirement; (2) if the coverage requirement is found unconstitutional, whether it is severable from the remainder of the ACA; (3) whether the ACA’s requirement that states expand Medicaid eligibility or risk losing federal funds is unduly coercive in violation of the Tenth Amendment; and (4) whether the individual coverage requirement is a tax for purposes of the Anti-Injunction Act, meaning that plaintiffs seeking to challenge the requirement must wait until it takes effect in 2014.

Oral arguments are set for March 26-28, 2012, and a decision is expected by the end of the Court’s term in late June of 2012.

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Supreme Court agrees to hear health reform challenges

Posted by mmcdowell on November 14, 2011

The U.S. Supreme Court has granted writ of certiorari (cert) to three appellate court cases involving multiple issues related to the constitutionality of the Affordable Care Act (ACA). The Court set aside 5-1/2 hours for oral arguments, which will likely take place in March. The justices will hear arguments on four issues: (1) the constitutionality of the individual mandate; (2) whether other provisions of the ACA should be severed (and remain in effect) if the individual mandate is found to be unconstitutional; (3) the applicability of the Anti-Injunction Act on whether the Court has jurisdiction to hear the cases, and; (4) the legality of the ACA’s Medicaid eligibility expansion.

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Federal Appeals Court for DC Circuit upholds ACA’s individual mandate

Posted by mmcdowell on November 8, 2011

The U.S. Court of Appeals for the District of Columbia Circuit upheld the Affordable Care Act’s (ACA’s) individual mandate provision, which requires nearly all Americans to buy health insurance by 2014. The American Center for Law and Justice, a legal group founded by evangelist Pat Robertson, brought the suit. The ruling comes days before the Supreme Court is expected to decide whether or not it will take up a case regarding this and other issues. Judge Laurence Silberman, a Reagan appointee, authored the 2-1 opinion. Senior Judge Harry Edwards, a Carter appointee, concurred with Silberman’s majority opinion. Judge Brett Kavanaugh, appointed by George W. Bush, dissented, arguing that he doesn’t think courts have jurisdiction to hear the case. The appeals court for the D.C. Circuit is the fourth appeals panel to consider a lawsuit challenging ACA provisions. Two appellate courts have now upheld the law, one has ruled it unconstitutional, and one declined to rule, based on Anti-Injunction Act procedural grounds.

Click here for an update on ACA legal challenges.

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