The Supreme Court upheld the Patient Protection and Affordable Care Act in a landmark 5-4 decision, which prompted many in business, the administration and states around the country to proceed with the Act’s implementation, while others are preparing for a major political effort to repeal the law.
IN THE COURTS
In a landmark decision, the Supreme Court upheld much of the Patient Protection and Affordable Care Act on Thursday (6/28), including the federal mandate to purchase health insurance, but not the power of the federal government to withhold Medicaid funds from states that choose not to participate in the law’s Medicaid expansions.
AT THE AGENCIES
Medicaid expansions planned under the Affordable Care Act now hang in the balance as state officials decide whether to participate in or opt out of the law’s Medicaid provisions. The Supreme Court effectively said states may implement the new Medicaid expansions included within the law and receive the financial benefits that accompany those expansions, or they may maintain their existing Medicaid programs without having to face a withholding of funds for those programs.
IN THE STATES
Texas is weighing whether to participate in or opt out of the Affordable Care Act’s Medicaid provisions, which, if implemented, would extend coverage to 1.8 million Texans, but also cost the state an estimated $2.6 billion between 2014 and 2019.
Republican governors in numerous states that were party to the case before the Supreme Court vowed to ignore the Court’s ruling at least until after the election.
ON THE HILL
Republican lawmakers on Capitol Hill are already discussing ways to repeal the Affordable Care Act, including the use of unconventional means such as reconciliation, which might allow portions to be repealed with only 51 votes in the Senate. There will likely be a symbolic vote to repeal the Affordable Care Act on July 11, but a larger campaign to repeal the legislation would, at a minimum, require Republicans to win the White House, gain seats in the Senate, maintain control of the House, and then proceed in near perfect unity on repeal efforts, likely including little-known legislative procedural moves.
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