Rochester, N.Y.—It’s a decision with big implications for the future of healthcare in America.
On Thursday, the United States Supreme Court will announce its decision regarding the constitutionality of President Barack Obama’s Affordable Care Act.
The law has divided the country. At the center of the controversy is the issue of individual mandates. The mandate would require every American to purchase insurance.
According to Ted Brown, a professor of History and Community Preventive Medicine at the University of Rochester, the Supreme Court can decide to strike down all, or parts of, the health care law.
However, if the court decides to uphold the law, there won’t be any immediate changes.
“Nothing will happen until 2014,” Brown says. “That's when it goes into effect. By that time, states are supposed to set up these exchanges or marketplaces where people can buy insurance for reasonable rates that meet federal criteria.”
Brown says some states against federal healthcare reform have threatened to not comply with the law. In that case, there will be a federal exchange.
Republican party leaders have also vowed to repeal the Affordable Care Act once the Supreme Court reveals its ruling.
If the Supreme Court strikes down the individual mandate portion of the law, Brown says the entire law may be in jeopardy.
For example, two portions of the law that have had wide-ranging approval is one that provides insurance for those with pre-existing conditions and another that allows people under 26-years-old to stay on their parents’ insurance.
Insurance companies claim that they are only able to do this if everyone is required to pay for insurance.
“[If the law is struck down] the insurance companies will balk,” says Brown “They’ll be saying we can't maintain the good things people liked about the Affordable Care Act.”
Regardless of what the Supreme Court decides, New York State already has the mechanism in place for a statewide insurance exchange.
In April 2010, Governor Andrew Cuomo issued an executive order establishing a statewide insurance exchange with more than $2 billion in subsidies--to be used by individuals and small businesses to purchase insurance.
In New York there are more than 2,880,000 uninsured people—that’s 15 percent of the state’s population.
Governor Cuomo’s office says, “New York will be in a good position if the federal law is upheld in its entirety, and appears on track to continue planning for a state insurance exchange, even if the law is struck down.”