Health Policy 101: Insurance Exchanges
What are they?
The Affordable Care Act (ACA) mandates that states develop Affordable Insurance Exchanges that will allow small businesses (<100 employees) and individuals to review, compare, and shop for both private and public insurance plans The exchanges will also make it clear if the individual or business is eligible for a tax credit. The ultimate goal of this initiative is to provide easy to understand, comparative information that will make choosing a plan easier. Exchanges will also create an administrative mechanism for easier enrollment. Because insurance companies can no longer deny applicants with pre-existing conditions, the exchanges will hopefully help reform the insurance market and make it more effective, as well as allow for monitoring of marketing practices. Additionally for an insurance plan to be included in the exchange it must meet a federal minimum requirement that stipulates what benefits must be included, among other things. While the individual and small business exchanges are technically separate programs, states have the option of combining the exchanges. There is no requirement for individuals or small businesses to use these exchanges, and an insurance market will continue to exist outside the exchange programs.
Why are they needed?
Historically small businesses have had a difficult time offering health insurance to employees, as premiums tend to be higher per worker due to the higher per person costs of administering a plan to a small group of people. The exchange program for small businesses (Small Business Health Options Program, aka SHOP) will make it easier for employers to compare plans and provide more choices to their employees without raising premiums. Both individual and SHOP exchanges must open enrollment by October 2013, and be fully functional by January 2014.
How will they function?
States have been given much latitude in determining how their exchanges programs will be executed. They may be an executive branch agency, and independent government authority, or a non-profit organization. States may also forge exchange partnerships with other states to cover a larger region. Additionally, if a state does not have a functional exchange in place by January 2014, or decides not do provide an exchange, the federal government will step in and partner with the state. States can also decide whether the exchanges will offer “any-willing-plan,” where any plan that meets minimum requirements would be part of the exchange, or states may be ‘active purchasers,’ where the state chooses what plans are in the best interest of their populations. It is estimated that by 2019, 28 million Americans will be covered through Affordable Insurance Exchanges.
Read the Robert Wood Johnson Foundation, Kaiser Family Foundation, Healthcare.gov sites for more detailed information.
Atul Grover, AAMC's Chief Public Policy Officer spoke with CSPAN last weekend and provides a overview of the issue. Video available on the AAMC's site here: https://www.aamc.org/newsroom/300770/cspanwj.html
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
More "Heath Policy 101" articles on the official OSR Legislative Affairs website
What are they?
The Affordable Care Act (ACA) mandates that states develop Affordable Insurance Exchanges that will allow small businesses (<100 employees) and individuals to review, compare, and shop for both private and public insurance plans The exchanges will also make it clear if the individual or business is eligible for a tax credit. The ultimate goal of this initiative is to provide easy to understand, comparative information that will make choosing a plan easier. Exchanges will also create an administrative mechanism for easier enrollment. Because insurance companies can no longer deny applicants with pre-existing conditions, the exchanges will hopefully help reform the insurance market and make it more effective, as well as allow for monitoring of marketing practices. Additionally for an insurance plan to be included in the exchange it must meet a federal minimum requirement that stipulates what benefits must be included, among other things. While the individual and small business exchanges are technically separate programs, states have the option of combining the exchanges. There is no requirement for individuals or small businesses to use these exchanges, and an insurance market will continue to exist outside the exchange programs.
Why are they needed?
Historically small businesses have had a difficult time offering health insurance to employees, as premiums tend to be higher per worker due to the higher per person costs of administering a plan to a small group of people. The exchange program for small businesses (Small Business Health Options Program, aka SHOP) will make it easier for employers to compare plans and provide more choices to their employees without raising premiums. Both individual and SHOP exchanges must open enrollment by October 2013, and be fully functional by January 2014.
How will they function?
States have been given much latitude in determining how their exchanges programs will be executed. They may be an executive branch agency, and independent government authority, or a non-profit organization. States may also forge exchange partnerships with other states to cover a larger region. Additionally, if a state does not have a functional exchange in place by January 2014, or decides not do provide an exchange, the federal government will step in and partner with the state. States can also decide whether the exchanges will offer “any-willing-plan,” where any plan that meets minimum requirements would be part of the exchange, or states may be ‘active purchasers,’ where the state chooses what plans are in the best interest of their populations. It is estimated that by 2019, 28 million Americans will be covered through Affordable Insurance Exchanges.
Read the Robert Wood Johnson Foundation, Kaiser Family Foundation, Healthcare.gov sites for more detailed information.
Atul Grover, AAMC's Chief Public Policy Officer spoke with CSPAN last weekend and provides a overview of the issue. Video available on the AAMC's site here: https://www.aamc.org/newsroom/300770/cspanwj.html
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
More "Heath Policy 101" articles on the official OSR Legislative Affairs website
1. House votes to repeal the Affordable Care Act
On July 11th the House voted 244-185 to pass the “Repeal of Obamacare Act” in hopes of overturning President Obama’s Affordable Care Act. This marks the 33rd time that the Republican-controlled House has voted to overturn the President’s health reform law since 2010. Yet, as with the previous bills passed in the House, this one is almost certain to be tabled in the Democrat-controlled Senate. This vote was largely viewed as symbolic, intended to get conservative voters excited about the November election and reaffirm the Republican stance on the law. The Kaiser Family Foundation has compiled news coverage on the topic.
Think you know what the ACA entails? Take the Kaiser Family Foundation quiz to find out how you compare to the rest of the country!
2. States consider opting out of Medicaid expansion
After the Supreme Court ruled that states were no longer required to participate in the Medicaid expansion, many governors have stated that they will not be expanding the program. Currently five Republican governors have announced that their states will be opting out: Florida, Louisiana, Mississippi, South Carolina, and Texas. An additional four states are leaning toward opting out as well. Ten are definitely expanding and 27 remain undecided. (CNBC) The governors opposed to the expansion believe that the expansion will crush their state budgets. On the other hand, a primary aim of the law is to expand health insurance coverage and this aim relies on the expansion of Medicaid. Hospitals may also suffer from state opt-outs, as many agreed to cut their reimbursement rates in exchange for the money they would collect from newly enrolled Medicaid patients. Without Medicaid expansion, hospitals would be left with reduced rates and continued large numbers of uninsured patients that they must care for. Washington Post
A Washington Post Infographic explains who would be most affected by states opting out:
A large subset of the population would be ineligible for Medicaid if a state opts out because they earn too much money (varies by state), but are also ineligible for insurance subsidies because they earn too little (less than 133% of the poverty line). Arkansas for example only provides Medicaid to families who earn less than 17% of the poverty line, so if the state opted out of the expansion, those who earned between 17% and 133% of the poverty line would remain uninsured.
3. Firefighters gain yearlong health coverage
Seasonal firefighters have been granted yearlong health insurance coverage similar to that of federal land management agencies. Just hours after representative Diana DeGette (D-Co) introduced the bill assuring health coverage for firefighters, President Obama ordered federal agencies to grant yearlong coverage to seasonal firefighters. This summer there are 10,000 seasonal firefighters who will gain coverage. The estimated cost of this expansion has not been released.
NPR
4. Mental illness coverage expanded in health law
Prior to the passage of the ACA, most insurance companies imposed annual and lifetime caps, high deductibles, or no coverage for treatment of mental illness and substance disorders. Though the Mental Health Parity and Addiction Equality Act of 2008 mandated that coverage be the same for psychiatric and medical illnesses, the limited application of the act (to large employers with benefits that already covered mental health) resulted in little effect. But now that this parity is combined with an individual mandate and coverage regardless of pre-existing conditions, care for those with psychiatric illness is likely to improve.
New York Times
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
On July 11th the House voted 244-185 to pass the “Repeal of Obamacare Act” in hopes of overturning President Obama’s Affordable Care Act. This marks the 33rd time that the Republican-controlled House has voted to overturn the President’s health reform law since 2010. Yet, as with the previous bills passed in the House, this one is almost certain to be tabled in the Democrat-controlled Senate. This vote was largely viewed as symbolic, intended to get conservative voters excited about the November election and reaffirm the Republican stance on the law. The Kaiser Family Foundation has compiled news coverage on the topic.
Think you know what the ACA entails? Take the Kaiser Family Foundation quiz to find out how you compare to the rest of the country!
2. States consider opting out of Medicaid expansion
After the Supreme Court ruled that states were no longer required to participate in the Medicaid expansion, many governors have stated that they will not be expanding the program. Currently five Republican governors have announced that their states will be opting out: Florida, Louisiana, Mississippi, South Carolina, and Texas. An additional four states are leaning toward opting out as well. Ten are definitely expanding and 27 remain undecided. (CNBC) The governors opposed to the expansion believe that the expansion will crush their state budgets. On the other hand, a primary aim of the law is to expand health insurance coverage and this aim relies on the expansion of Medicaid. Hospitals may also suffer from state opt-outs, as many agreed to cut their reimbursement rates in exchange for the money they would collect from newly enrolled Medicaid patients. Without Medicaid expansion, hospitals would be left with reduced rates and continued large numbers of uninsured patients that they must care for. Washington Post
A Washington Post Infographic explains who would be most affected by states opting out:
A large subset of the population would be ineligible for Medicaid if a state opts out because they earn too much money (varies by state), but are also ineligible for insurance subsidies because they earn too little (less than 133% of the poverty line). Arkansas for example only provides Medicaid to families who earn less than 17% of the poverty line, so if the state opted out of the expansion, those who earned between 17% and 133% of the poverty line would remain uninsured.
3. Firefighters gain yearlong health coverage
Seasonal firefighters have been granted yearlong health insurance coverage similar to that of federal land management agencies. Just hours after representative Diana DeGette (D-Co) introduced the bill assuring health coverage for firefighters, President Obama ordered federal agencies to grant yearlong coverage to seasonal firefighters. This summer there are 10,000 seasonal firefighters who will gain coverage. The estimated cost of this expansion has not been released.
NPR
4. Mental illness coverage expanded in health law
Prior to the passage of the ACA, most insurance companies imposed annual and lifetime caps, high deductibles, or no coverage for treatment of mental illness and substance disorders. Though the Mental Health Parity and Addiction Equality Act of 2008 mandated that coverage be the same for psychiatric and medical illnesses, the limited application of the act (to large employers with benefits that already covered mental health) resulted in little effect. But now that this parity is combined with an individual mandate and coverage regardless of pre-existing conditions, care for those with psychiatric illness is likely to improve.
New York Times
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
Health Policy 101: Medicaid Expansion – What is it, how was it affected, and what will its impact be on the health care system?
Medicaid is the country’s health insurance program for low-income and vulnerable populations. Medicaid provides health coverage to about 60 million Americans, including pregnant women, elderly and more than 31 million children. The federal government sets minimum guidelines for Medicaid eligibility but states can choose to expand coverage beyond the minimum threshold, which is typically determined by a percentage of the federal poverty level.
Within the ACA, there was a provision that would require states to expand Medicaid coverage in 2014 to a minimum threshold of 133% of the federal poverty level (approximately $31,000 a year for a family of four). This expansion would provide access to health insurance for an additional 17 million Americans. For the first two years, the federal government would pay for 100% the costs of this expansion, but in subsequent years federal government’s contribution would drop as low as 90% and the state would have to pay for the rest.
A controversial part of the ACA’s Medicaid expansion was that the federal government would have the ability to withhold all Medicaid funding to states if they did not fully comply with the expansion. Justice Roberts’ decision deemed this provision unconstitutional, indicating that this “financial ‘inducement’… is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion." As a result, the federal government can no longer use this measure of withholding funds to make states participate in the Medicaid expansion.
The results of this decision appear unclear. The court ruling allows the states the option to not participate in the Medicaid expansion without having to face the threat of losing entire Medicaid funding from the federal government. This could lead certain states which are facing budget restraints to consider not participating in the Medicaid expansion due to their inability to afford the costs after the federal government would reduce their funding in 2016. This could potentially leave affordable health insurance out of reach for millions. Other forces, however, could compel states to take part in the expansion, such as advocacy from interest groups focused on the health status of low-income families, hospital organizations, or incentives from the federal government.
For physicians and hospitals, this could impact the insurance status of their patient populations. Organizations such as the AAMC is continuing to closely examine the court’s ruling on the Medicaid expansion and how it will affect academic medical colleges throughout the country.
Source: http://www.kaiserhealthnews.org/Stories/2012/June/28/supreme-court-upholds-individual-mandate.aspx
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
More "Heath Policy 101" articles on the official OSR Legislative Affairs website
Medicaid is the country’s health insurance program for low-income and vulnerable populations. Medicaid provides health coverage to about 60 million Americans, including pregnant women, elderly and more than 31 million children. The federal government sets minimum guidelines for Medicaid eligibility but states can choose to expand coverage beyond the minimum threshold, which is typically determined by a percentage of the federal poverty level.
Within the ACA, there was a provision that would require states to expand Medicaid coverage in 2014 to a minimum threshold of 133% of the federal poverty level (approximately $31,000 a year for a family of four). This expansion would provide access to health insurance for an additional 17 million Americans. For the first two years, the federal government would pay for 100% the costs of this expansion, but in subsequent years federal government’s contribution would drop as low as 90% and the state would have to pay for the rest.
A controversial part of the ACA’s Medicaid expansion was that the federal government would have the ability to withhold all Medicaid funding to states if they did not fully comply with the expansion. Justice Roberts’ decision deemed this provision unconstitutional, indicating that this “financial ‘inducement’… is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion." As a result, the federal government can no longer use this measure of withholding funds to make states participate in the Medicaid expansion.
The results of this decision appear unclear. The court ruling allows the states the option to not participate in the Medicaid expansion without having to face the threat of losing entire Medicaid funding from the federal government. This could lead certain states which are facing budget restraints to consider not participating in the Medicaid expansion due to their inability to afford the costs after the federal government would reduce their funding in 2016. This could potentially leave affordable health insurance out of reach for millions. Other forces, however, could compel states to take part in the expansion, such as advocacy from interest groups focused on the health status of low-income families, hospital organizations, or incentives from the federal government.
For physicians and hospitals, this could impact the insurance status of their patient populations. Organizations such as the AAMC is continuing to closely examine the court’s ruling on the Medicaid expansion and how it will affect academic medical colleges throughout the country.
Source: http://www.kaiserhealthnews.org/Stories/2012/June/28/supreme-court-upholds-individual-mandate.aspx
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
More "Heath Policy 101" articles on the official OSR Legislative Affairs website
For anyone interested in the following opportunity, please contact one of the CWRU OSR Reps for more information ([email protected]). Meetings can occur anytime between August 6th and September 7th. This is a very significant commitment, so check your schedule accordingly before applying.
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(From William Teeter, National Delegate) -
Are you interested in meeting your Congressional representatives? Would you like the opportunity to discuss AAMC healthcare priorities with them in person?
In the coming days, you will receive more information on the OSR District “Hill Day” from August 6th through September 6th. In general, we are seeking interested OSR representatives who are willing to meet with their Representatives and Senators. The meetings will be coordinated by you with the help of the AAMC Advocacy Office and Matthew Shick, AAMC Government Relations, during the congressional district work period. During this time, your representatives will be in their home districts and may be available for meetings with constituents. This is a great opportunity to get involved in changing healthcare policy by representing academic medicine.
If this is a bit overwhelming, I will promise you two things:
1. A great experience.
2. You will be well prepared knowing exactly what you should discuss
In return for this, we only ask the following:
1. Read ALL of these instructions
2. Register your meeting at the AAMC links provided.
3. Stay tuned for any emails that Matt Shick, Ally Anderson, or myself send on the Hill Day.
That’s it! Thank you for your support and I hope we can make this is a worthwhile event.
William “Bill” Teeter, MD
OSR Legislative Affairs National Delegate
General Surgery Resident
University of Maryland
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(From William Teeter, National Delegate) -
Are you interested in meeting your Congressional representatives? Would you like the opportunity to discuss AAMC healthcare priorities with them in person?
In the coming days, you will receive more information on the OSR District “Hill Day” from August 6th through September 6th. In general, we are seeking interested OSR representatives who are willing to meet with their Representatives and Senators. The meetings will be coordinated by you with the help of the AAMC Advocacy Office and Matthew Shick, AAMC Government Relations, during the congressional district work period. During this time, your representatives will be in their home districts and may be available for meetings with constituents. This is a great opportunity to get involved in changing healthcare policy by representing academic medicine.
If this is a bit overwhelming, I will promise you two things:
1. A great experience.
2. You will be well prepared knowing exactly what you should discuss
In return for this, we only ask the following:
1. Read ALL of these instructions
2. Register your meeting at the AAMC links provided.
3. Stay tuned for any emails that Matt Shick, Ally Anderson, or myself send on the Hill Day.
That’s it! Thank you for your support and I hope we can make this is a worthwhile event.
William “Bill” Teeter, MD
OSR Legislative Affairs National Delegate
General Surgery Resident
University of Maryland
1. Supreme Court upholds Affordable Care Act
On Thursday, in a 5-4 decision, the Supreme Court upheld President Obama’s health care law, the Patient Protection and Affordable Care Act (ACA). The ruling kept intact the majority of the legislation by agreeing with the key provision that “the requirement for nearly all Americans to secure insurance is permissible under Congress’s taxing authority.” This portion of the law, known as the individual mandate, would require Americans to obtain health insurance by 2014.
The opinion was written by Chief Justice John G. Roberts Jr. and included a complex discussion about the constitutionality of the law. It indicated that while the mandate itself was deemed unconstitutional under the Commerce Clause of the Constitution, it was ultimately upheld because the penalty for not having health insurance is a tax, which is a constitutional act that Congress can make.
Chief Justice Roberts was joined by the four liberal justices on the Supreme Court in supporting the ruling. In their dissenting opinion, the other four justices stated that the law should be rejected in its entirety.
Source: The Washington Post
2. Responses from key leaders and experts about the SCOTUS decision
Many physician and health organizations applauded the announcement from the Supreme Court on the ACA, including the AAMC. In a press release, AAMC President and CEO Darrell G. Kirch, M.D. expressed the organization’s pleasure with the announcement stating, “This law is an important step toward an improved health care system that gives all Americans access to the care they need when they need it.” His remarks pointed beyond the main provision of the individual mandate, emphasizing that the decision to uphold the ACA “allows the important work of the Center for Medicare and Medicaid Innovation (CMMI), the Patient-Centered Outcomes Research Institute (PCORI), and the programs supported by the Prevention and Public Health Fund to continue.” Finally, Dr. Kirch reiterated the need for increased funding for residency slots to prepare future physicians who can ensure that Americans have access to health care as well as health insurance.
Other organizations, such as Kaiser Health News, brought together leading health policy experts to sit down and discuss the details of the ruling and its broader impact on the U.S. health care system. You can view the enlightening discussion at the link provided below.
Source: The Association of American Medical Colleges
Video: Kaiser Health News
3. Moving forward: What is around the bend in implementing the ACA?
For patients, all of the provisions that have been enacted by the law will remain in place, including the ability for children under age 26 to remain on their parents’ health insurance plan, the restriction on lifetime limits, and protections for children with preexisting conditions to gain insurance. In 2014, there will be a requirement for Americans to obtain health insurance along with the implementation of state health insurance exchanges and federal subsidies to help make insurance more affordable.
For the physicians and the health care system, this means that there are continued investments to increase the amount of insured patients and to spark innovations to increase the quality and efficiency of the health care system overall. For example, the Center for Medicare and Medicaid Innovation will continue to be funded through the law, along with other efforts to improve health care delivery. However, with the increase in insured patients and current number of physicians, the nation’s physician shortage will be expected to grow significantly in the upcoming years.
For many states, there will be both a rush to match requirements set in place by the ACA as well as a new ability to reject some of the insurance expansions that the law seeks to implement. In the next 16 months, states will be expected to meet requirements such as the launch of new state-based marketplaces where consumers will shop for coverage, and the fining of employers with 50 or more workers who fail to provide affordable coverage. For some states that waited to hear the ruling before beginning implementation, there will be a lot of work needed to meet deadlines for progress on these provisions. States will, however, have the option to not take part in the Medicaid expansion, which was deemed unconstitutional in Justice Roberts’ decision. A further discussion of this issue is included below.
Sources:
The Washington Post
The Association of American Medical Colleges
Kaiser Health New
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate
On Thursday, in a 5-4 decision, the Supreme Court upheld President Obama’s health care law, the Patient Protection and Affordable Care Act (ACA). The ruling kept intact the majority of the legislation by agreeing with the key provision that “the requirement for nearly all Americans to secure insurance is permissible under Congress’s taxing authority.” This portion of the law, known as the individual mandate, would require Americans to obtain health insurance by 2014.
The opinion was written by Chief Justice John G. Roberts Jr. and included a complex discussion about the constitutionality of the law. It indicated that while the mandate itself was deemed unconstitutional under the Commerce Clause of the Constitution, it was ultimately upheld because the penalty for not having health insurance is a tax, which is a constitutional act that Congress can make.
Chief Justice Roberts was joined by the four liberal justices on the Supreme Court in supporting the ruling. In their dissenting opinion, the other four justices stated that the law should be rejected in its entirety.
Source: The Washington Post
2. Responses from key leaders and experts about the SCOTUS decision
Many physician and health organizations applauded the announcement from the Supreme Court on the ACA, including the AAMC. In a press release, AAMC President and CEO Darrell G. Kirch, M.D. expressed the organization’s pleasure with the announcement stating, “This law is an important step toward an improved health care system that gives all Americans access to the care they need when they need it.” His remarks pointed beyond the main provision of the individual mandate, emphasizing that the decision to uphold the ACA “allows the important work of the Center for Medicare and Medicaid Innovation (CMMI), the Patient-Centered Outcomes Research Institute (PCORI), and the programs supported by the Prevention and Public Health Fund to continue.” Finally, Dr. Kirch reiterated the need for increased funding for residency slots to prepare future physicians who can ensure that Americans have access to health care as well as health insurance.
Other organizations, such as Kaiser Health News, brought together leading health policy experts to sit down and discuss the details of the ruling and its broader impact on the U.S. health care system. You can view the enlightening discussion at the link provided below.
Source: The Association of American Medical Colleges
Video: Kaiser Health News
3. Moving forward: What is around the bend in implementing the ACA?
For patients, all of the provisions that have been enacted by the law will remain in place, including the ability for children under age 26 to remain on their parents’ health insurance plan, the restriction on lifetime limits, and protections for children with preexisting conditions to gain insurance. In 2014, there will be a requirement for Americans to obtain health insurance along with the implementation of state health insurance exchanges and federal subsidies to help make insurance more affordable.
For the physicians and the health care system, this means that there are continued investments to increase the amount of insured patients and to spark innovations to increase the quality and efficiency of the health care system overall. For example, the Center for Medicare and Medicaid Innovation will continue to be funded through the law, along with other efforts to improve health care delivery. However, with the increase in insured patients and current number of physicians, the nation’s physician shortage will be expected to grow significantly in the upcoming years.
For many states, there will be both a rush to match requirements set in place by the ACA as well as a new ability to reject some of the insurance expansions that the law seeks to implement. In the next 16 months, states will be expected to meet requirements such as the launch of new state-based marketplaces where consumers will shop for coverage, and the fining of employers with 50 or more workers who fail to provide affordable coverage. For some states that waited to hear the ruling before beginning implementation, there will be a lot of work needed to meet deadlines for progress on these provisions. States will, however, have the option to not take part in the Medicaid expansion, which was deemed unconstitutional in Justice Roberts’ decision. A further discussion of this issue is included below.
Sources:
The Washington Post
The Association of American Medical Colleges
Kaiser Health New
Your loyal Legislative Affairs team,
Brad Hunter – Northeast Region
Robert Sanchez – Central Region
Sean Vanlandingham – Southern Region
Claire Sadler – Western Region
William Teeter – National Delegate