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Health & Fitness

United States Supreme Court Upholds the Affordable Care Act (ACA)

On Thursday, the Supreme Court of the United States issued a landmark decision upholding the Affordable Care Act (ACA).

. There were two surprises in the opinion - the Court upheld the constitutionality of the entire Act, including the controversial individual mandate; and Chief Justice Roberts was the swing vote, writing the opinion for the majority.

In the past two years, the law has saved over $3 billion in Medicare prescription drug costs for older and disabled Americans, put $1.1 billion in rebates back in the pockets of 12.8 million consumers, and allowed over 3 million young adults to retain access to health coverage on their parents' health plans. Additional provider incentives and community resources will go into effect in the coming years.

ACA strengthens and improves the Medicare program. As a result of the Supreme Court ruling today, these Medicare improvements will continue, including:

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*Extending the solvency of the Medicare program

*Eliminating the Part D prescription drug Donut Hole coverage gap by 2020

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*As a result of ACA, there is 50% discount for brand drugs and a 14% discount for generics for people who hit the Donut Hole in 2012

*Eliminating cost-sharing for preventive services

*Adding new preventive services

*Reining in over payments to private Medicare Advantage plans

*Implementing demonstration and pilot programs to improve quality of care while reducing costs

*Expanding consumer protections for individuals in private Medicare Advantage plans, including prohibitions against charging more than traditional Medicare for certain high-cost services

The second major ruling today had to do with the Act's expansion of the Medicaid program. The Act expands the scope of the program and increases the number of individuals the states must cover.

For example, the Act requires state programs to provide Medicaid coverage to all adults with incomes up to 133% of the federal poverty level. The federal government would pay for 100% of the increase through 2016, after which the federal government's funding would gradually be reduced to no less than 90%. The Act provides that states that don't expand coverage would lose all federal funding for Medicaid.

The Court held that this was a "gun to the head" of the states. The threat of losing all federal funding was not an inducement but a compulsion. Therefore, the court held it was not a constitutional exercise of the taxing and spending power of Congress. It does seem that the states will be given the choice of either continuing current Medicaid funding or receiving expanded coverage. However, they will not be penalized (lose federal funding) for refusing to expand coverage. 

Stay well until the next post: 

Written by Rajiv Nagaich, Esq. of Federal Way, WA - edited by Bob Gasparro, Esq. of Haverford PA. Both members of National Academy of Elder Law Attorneys. Used here with permission of Raviv Nagaich, Esq. 

For more information, visit www.agingoptions.com and www.lifespanlegal.com.

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