The Affordable Care Act (ACA) brings real benefits to tens of millions of people, and the Supreme Court’s decision ensures improved access to health care for people with Medicare and their families. In upholding the law, the Court has made certain that millions of people with Medicare will continue to see billions of dollars in savings on prescription drugs through the closure of the Part D doughnut hole and have ongoing access to preventive care services at no out-of-pocket cost.
 
As a result of the ACA, which was signed into law in March 2010, over 5.2 million Medicare beneficiaries have saved more than $3.7 billion on prescription drugs to date, and 32.5 million people with Medicare accessed preventive services, including mammograms, prostate cancer screenings and the annual wellness visit in 2011 alone.
 
Additionally, the ACA has already brought federal payments to Medicare Advantage plans more in line with costs under Original Medicare and has improved the financial health of the Medicare program, putting Medicare in a stronger position to serve older adults and people with disabilities in the future.
 
The Supreme Court’s decision means that seniors and people with disabilities will be able to look forward to the law’s future benefits, including closure of the Medicare Part D doughnut hole by 2020; a new requirement that Medicare Advantage plans use at least 85% of revenues on beneficiaries’ medical services rather than overhead and salaries; and increased solvency of the Medicare Hospital Trust Fund for an additional 8 years, until 2024.
 


"The Supreme Court’s decision is the most important safety net related decision since the Social Security Act was upheld by the Court in 1937. It validates Congress’ clear intent to improve seniors’ health and well-being and uphold all of the provisions important to all older adults." Paul Nathanson, National Senior Citizens Law Center Executive Director
 
"Health care reform is vital for the economic health of our nation and the Medicare and Medicaid programs. Today’s decision helps move our nation forward while also protecting America’s elderly, poor, sick, and uninsured by preserving billions of dollars in benefits and countless provisions to cut waste, fraud and abuse that extend these programs’ solvency." Max Richtman, NCPSSM President/CEO
 
The National Senior Citizens Law Center and the National Committee to Preserve Social Security and Medicare have released new analysis detailing the positive impact the Supreme Court’s decision to uphold the Affordable Care Act will have on older Americans. Virtually every American family will be touched by today’s ruling but America’s elderly will feel the effects in these ways:
 
– Seniors will continue to receive prescription drug savings through brand name and generic discounts
– The Part D prescription drug coverage gap known as the ‘donut hole’ will continue to be phased out
– Covered annual wellness visits for beneficiaries will continue to be provided in Medicare
– Seniors will pay less for preventive services. Under the ACA, Medicare will fully cover screenings like mammograms, pap smears, bone mass measurements, depression screening, diabetes screening, HIV screening and obesity screenings
– Almost 3.3 million uninsured individuals ages 50-64 will be insured through Medicaid
– 8 years has been added to Medicare’s solvency thanks to the Affordable Care Act
 
The future of an estimated 3.3 million uninsured young seniors, ages 50-64, who would have received health coverage under Medicaid and many of the 16 million older adults and individuals with disabilities who rely on Medicaid for long-term services and supports, is less certain with this ruling as the Court has limited the government’s ability to penalize states who do not participate in the expansion of Medicaid.


The U.S. Supreme Court decision today upheld the linchpin of the Affordable Care Act by ruling 5-4 that the government can tax individuals who choose not to buy health insurance.
 
The principal opinion was written by Chief Justice John Roberts.
 
Five members of the Court agreed that the requirement that individuals either purchase health insurance or make an additional payment on their federal income taxes – the so-called individual mandate – was a constitutionally permissible tax imposed on those who did not purchase health insurance.
 
The individual mandate was thus upheld even though five members of the Court, including Chief Justice Roberts, rejected the government’s principal argument that the individual mandate was a proper exercise of Congress’ power under the Commerce Clause.
 
Five members of the Court also agreed that Congress could withhold new Medicaid funds from states that did not expand their Medicaid coverage as required by the new health care law, but could not withhold funds for pre-existing Medicaid programs.
 
“The ACLU welcomes today’s decision, which recognizes that Congress has the constitutional authority to fix a health care system that does not work for millions of Americans,” said Steven R. Shapiro, ACLU legal director. “The decision is especially welcome for disadvantaged minorities, who are more likely to be uninsured, and for women, who are more likely to suffer gaps and discrimination in their health care coverage.  We trust that the states will recognize those needs and accept the additional funds that the federal government is offering under the new law to expand Medicaid coverage for needy individuals.”


Tom Van Coverden, President and CEO National Association of Community Health Centers (NACHC), released the following statement today:
 
The U.S. Supreme Court today announced its decision on the Affordable Care Act (ACA). By upholding the constitutionality of the health reform law, the Court has assured that millions of currently-uninsured Americans will have the opportunity to gain insurance coverage over the next few years and that consumers will have vital protections and benefits under the law.  
 
The overall ruling will allow most of the ACA to proceed to full implementation. We are especially pleased that the Court’s decision reaffirms support for expanding access to health care through the nationwide network of Community Health Centers to more people in more communities across America. This means that in the years ahead millions of newly insured people, and communities identified as medical shortage areas, will gain access to doctors, nurses and other health care professionals, and the quality, cost-effective primary and preventive services our health centers provide.
 
The only disappointment in the ruling for health centers and the patients they serve is the weakening of the Medicaid expansion. This potentially leaves some of the 16 million eligible low-income people with no affordable coverage alternative, and it possibly denies many of these hard-working Americans the security of having insurance for their health care needs, no matter how complex or serious they may be. 
 
Nevertheless, now it is time to prepare for full implementation of the health reform law. Most of the 16 million people who hopefully will gain coverage under Medicaid expansion in 2014, and many of the additional 16 million people who will be able to purchase coverage through the new state Health Insurance Exchanges, live and work in the same communities that health centers serve. As health care advocates, Community Health Centers will have a major role in creating public awareness and understanding of the law’s benefits and protections, and in helping community residents who qualify to enroll with their Medicaid agencies or the Exchanges so that they are able to gain access to health care that all people need and deserve.


In response to the United States Supreme Court’s decision to uphold the individual mandate of the Patient Protection and Affordable Care Act, Dr. David Seaberg, president of the American College of Emergency Physicians (ACEP), today issued the following statement:
 
“The nation’s emergency physicians fully support the emergency care provisions in the law, such as inclusion of emergency services as an essential part of any health benefits package and the prudent layperson standard, which guarantees that health plans base coverage on the patient’s symptoms, not the final diagnosis. And regardless of the Supreme Court’s decision, it does not change the mission of emergency physicians. We pledge to be there for our patients.
 
“However, while there are provisions in the law to benefit emergency patients, it is clear that emergency visits will increase, as we have already seen nationwide. There are physician shortages and there are also drug shortages and serious mismatches between patient needs and available resources. 
 
“The need to shore up our nation’s emergency departments is as urgent as ever. People come to the ER because they are sick, because they need help, because they feel – according to a recent CDC report – that ‘only a hospital could help.’ A recent study in Annals of Emergency Medicine shows that crowding in emergency departments is growing twice as fast as the rate of ER visits, principally because emergency patients are showing up sicker and with more complicated health problems.
 
“As the nation moves forward with implementing the health care reform law, we urge the Senate to follow the lead of the House in repealing the Independent Payment Advisory Board, which was included in the law. The IPAB panel does not have any accountability to Congress, health care providers or the public and will harm Medicare patients’ access to medical care.
 
“Medicaid is intended as one of the means of expanding coverage. Increasing the number of patients on Medicaid without an equivalent increase in the number of physicians willing to take that insurance will surely increase the flood of patients into our nation’s ERs. Coverage does not equal access and critical problems facing emergency patients are not going away.
 
“ACEP has worked with — and will continue to work with — members of Congress to find solutions to improve the safety and efficiency of emergency care for all Americans. ERs are a critical, life-or-death part of our health care system and ERs need help now. This crisis in emergency care is everyone’s problem, because every person is only one step away from a medical emergency.”
 
Dr. Seaberg adds that this law also includes medical liability dispute resolution alternatives, but that the scope is extremely limited, which limits its potential effectiveness. America’s medical liability system is broken and without true medical liability reform, patients’ access to lifesaving care will continue to suffer.