Supreme Court Affirms Affordable Care Act, Coverage in Sight for 900,000 Uninsured Direct-Care Workers

Today, the Supreme Court upheld the Affordable Care Act (ACA), which extends health coverage to 32 million uninsured Americans. The Court upheld the constitutionality of the crucial and most controversial feature of the ACA, the individual mandate.

This is a big win for direct-care workers, providing health security to the 900,000 workers living without coverage. These workers will now have affordable coverage options.

Now direct-care workers and millions of Americans and their families will continue to receive the many benefits of the health care law:

• Insurance companies cannot deny insurance coverage because of a pre-existing condition, or end coverage when you get sick.
• Elders receive free preventive services through Medicare and a 50 percent discount on prescription drugs when they hit the “donut hole.”
• Insurers cannot charge higher prices for policies covering women.
• Small businesses get tax credits to purchase insurance.
• There are no more lifetime limits on coverage.
• At least 15 million more people will receive coverage because of expanded access to Medicaid, and millions more will receive tax credits to help them afford coverage.

Medicaid Eligibility Expansion Altered

The Court ruled that the ACA’s provision to expand Medicaid coverage for low-income Americans is constitutional, but that the government cannot withhold all Medicaid matching funds from states that do not participate.

PHI will continue to analyze how this provision affects direct-care workers.

A PHI analysis shows that more than 350,000 currently uninsured workers would be eligible for Medicaid beginning 2014 if all states participate. Under the expansion, Medicaid coverage would be available to all those living in households with incomes under 138 percent of the federal poverty guidelines ($26,344 for a family of three).

Though states may choose not to participate in the expanded Medicaid program, under the ACA, the federal government would cover 100 percent of the states’ cost of covering newly eligible Medicaid beneficiaries from 2014 to 2016. The federal share will then phase down to 90 percent by 2020. (Coverage for previously eligible Medicaid beneficiaries will continue to be financed at current federal matching rates which range from 50 percent to 74 percent.)

The 5-4 decision was written by Chief Justice John Roberts and was joined by Justices Stephen Breyer, Ruth Bader Ginsberg, Sonia Sotomayor, and Elena Kagan. Justice Anthony Kennedy wrote the minority opinion and was joined by Justices Antonin Scalia, Clarence Thomas, and Samuel Alito.

A more detailed PHI analysis of the decision will be forthcoming.

Further coverage:

• WTTG, Washington DC’s Fox affiliate, interviewed PHI Government Affairs Director Carol Regan (starts at 5:04:09).
• PHI’s press statement, Supreme Court Affirms Affordable Care Act.
• Caring Across Generations Campaign Co-Director Ai-jen Poo‘s op-ed published by CNN on how the health care law will benefit elders and direct-care workers.

— by Carol Regan, PHI Government Affairs Director