The initial news last week was that the Supreme Court upheld the Affordable Care Act (ACA). And though that remains true, discussion has increasingly focused on the one limitation the Court put on the law. While the ACA required all states to expand Medicaid eligibility to 133% of the federal poverty level (FPL) – about $30,000 for a family of four – in order to receive any federal Medicaid funds, the Court ruled that only funds for the expansion itself could be withheld. The practical effect of the limitation was to make it optional for states to expand Medicaid to all Americans at or below 133% FPL.
Immediately following today’s decision by the U.S. Supreme Court upholding the constitutionality of the Affordable Care Act, leading state legislators from across the nation are already pledging to continue implementing the provisions of the law as fully and quickly as possible, as the focus of health care reform once again returns to the states.
Forty-eight states and the District of Columbia have separately adopted at least one of the consumer protections in the Affordable Care Act as state law. No matter what the Supreme Court decides about the federal law, consumers in those 48 states continue to have at least some protection from the abusive practices of health insurance companies.
A group of state legislators who support the health law have discussed what they could do to replace the insurance mandate, if the court strikes it down, said Karen Keiser, a Democratic state senator in Washington who chairs the group. Possibilities for replacing a federal mandate include the “politically difficult” route of passing state versions of the mandate, or replacing private insurers with government-run coverage in some states, Keiser said. “It’s much more likely that states would step in and take it on because it seems the Congress is really at impasse,” she said by phone. In states that choose not to act, she said, “a large number of Americans would be left out and left behind.”
Maine state Rep. Sharon Anglin Treat, D-Hallowell, walked out of the U.S. Supreme Court on Monday after listening to the first round of oral arguments over President Obama's health care law and shook her head at the contrast. Inside the august chamber, where Treat snared a third-row seat after getting in line at 5:20 a.m., the justices quizzed all sides on fine legal points as the rapt audience looked on.
As historic oral arguments over the lawsuit seeking to overturn the Affordable Care Act opened today at the U.S. Supreme Court, a group of hundreds of state legislators representing every state in the nation continued to voice their support for the health law, underscoring that the Attorneys General bringing the lawsuit are not the only ones who speak for the states.