Our Health Policy Matters

Are you ecstatic, happy, neutral, sad, or devastated about the Supreme Court’s ruling upholding almost all of the Affordable Care Act? The answer may depend on your politics, but it more likely has everything to do with what the ruling means for you and the people you care about. Back in March, I wrote a column entitled “ How We Really Hope the Supreme Court Will Rule on the Affordable Care Act .”  Now you’ve heard pundits, politicians, and public officials tell you how to feel, let’s recap where you might really stand on the decision . Let’s start with your policy views. If you favor a single payer, “Medicare-for-all” program:  You’re devastated. Your only real hope for resurrecting “Medicare for all” was if the individual mandate was thrown out.  It wasn’t.  You may have Medicaid and Medicare expansions, but over the long haul that probably won’t be enough for you.  If you want a market-driven insurance environment, where insurers com...

Are you ecstatic, happy, neutral, sad, or devastated about the Supreme Court’s ruling upholding almost all of the Affordable Care Act? The answer may depend on your politics, but it more likely has everything to do with what the ruling means for you and the people you care about. Back in March, I wrote a column entitled “ How We Really Hope the Supreme Court Will Rule on the Affordable Care Act .”  Now you’ve heard pundits, politicians, and public officials tell you how to feel, let’s recap where you might really stand on the decision . Let’s start with your policy views. If you favor a single payer, “Medicare-for-all” program:  You’re devastated. Your only real hope for resurrecting “Medicare for all” was if the individual mandate was thrown out.  It wasn’t.  You may have Medicaid and Medicare expansions, but over the long haul that probably won’t be enough for you.  If you want a market-driven insurance environment, where insurers com...

We’re now just a little more than a month away from the day the Supreme Court will hear the arguments that determine the fate of the Affordable Care Act.   The fight will be narrow – about the constitutionality of the individual mandate and Medicaid expansions.   The consequences for health care financing, however, will be widespread. And, ironically, both states rights conservatives and pro-national health insurance progressives may end up rooting against their own positions. To understand why, consider the four ACA Supreme Court issues that will be argued.  The first is the constitutionality of the individual mandate under the Commerce Clause of the Constitution.   To be constitutional under the Commerce Clause, a law has to regulate economic activity that “has a substantial effect” on interstate commerce.  While it may seem that all the activity under ACA will have a substantial effect on interstate commerce, Judge Vinso...

We’re now just a little more than a month away from the day the Supreme Court will hear the arguments that determine the fate of the Affordable Care Act.   The fight will be narrow – about the constitutionality of the individual mandate and Medicaid expansions.   The consequences for health care financing, however, will be widespread. And, ironically, both states rights conservatives and pro-national health insurance progressives may end up rooting against their own positions. To understand why, consider the four ACA Supreme Court issues that will be argued.  The first is the constitutionality of the individual mandate under the Commerce Clause of the Constitution.   To be constitutional under the Commerce Clause, a law has to regulate economic activity that “has a substantial effect” on interstate commerce.  While it may seem that all the activity under ACA will have a substantial effect on interstate commerce, Judge Vinso...