Meeting the challenges
Ruling means full attention can be turned to building exchanges, enrollment
With last week’s ruling, we can now keep moving forward to ensure that people in this country will have the peace of mind that comes from knowing that they and their loved ones are sure to get the healthcare they need when they need it.
We are now closer than ever to ensuring that people with pre-existing conditions— such as children with asthma or diabetes— will not be denied coverage or charged discriminatory premiums. People with major health problems, such as those in car accidents, will no longer face annual or lifetime limits on their coverage. Women will no longer be charged higher healthcare premiums simply because they are women. Tens of millions of Americans will soon have the security of good quality, affordable health insurance. And the millions of others who are already enjoying benefits of the law—from young adults now covered on their parents’ plans to seniors saving money on prescription drugs—can rest easy knowing their protection will not be taken away.
Regarding Medicaid, while I would have preferred that the U.S. Supreme Court leave intact the entire Medicaid provision, I am optimistic that the ruling will have little practical effect. Under the Patient Protection and Affordable Care Act, the federal government will pay 100% of the costs of covering the roughly 16 million newly eligible Medicaid beneficiaries for the first three years the law is in effect, and never less than 90% of the costs thereafter. This compares with a federal share averaging 57% of the costs under the regular program.
Although states, under today’s ruling, are no longer required to expand their Medicaid program, the offer of 90% to 100% federal funding to cover the healthcare costs of their lowest-income residents is sure to appeal to people in every state. All states have already done this with the optional Children’s Health Insurance Program, which has a lower federal matching rate. Even an ideologically driven governor would be committing fiscal malpractice by rejecting the expansion.
With the legal battles behind us, we at last can turn our full attention to some of the most challenging and practical tasks that lie ahead in the next few years, from building the insurance marketplaces, known as exchanges, to the massive outreach and enrollment efforts needed to make sure that people know about, and take advantage of, the new coverage options that will soon be available to them.
The public, private and not-for-profit sectors must collaborate on outreach and public education so that people can learn about and choose the healthcare options that are best for them. This is not always glamorous work, but it is essential to making the law reach its full potential.