Even with the lingering uncertainty over Medicaid program expansion, the High Court’s decision brings some certainty and the need to focus on ramifications of ACA implementation.
On June 28, the U.S. Supreme Court held that the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148 or ACA) is constitutional with modifications to the Medicaid expansion provisions. In a 5-4 decision, the Supreme Court (i) upheld the individual mandate as a lawful exercise of Congress’s taxing power and (ii) ruled that states could opt out of the ACA’s future expansion of the Medicaid program without losing federal funding for their Medicaid programs as they currently exist. The ACA requires states to expand Medicaid coverage to all individuals with an income of up to 133% of the federal poverty level or lose all federal Medicaid matching funds. The Supreme Court held that Congress could not threaten to deny current Medicaid funding if states choose not to go forward with the ACA’s expansion of the Medicaid program. The Supreme Court’s decision means that states will now have the ability to opt out of this part of the ACA’s healthcare reform program.