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Supreme Court Ruling on the Affordable Care Act

Background: Over the past few months we've been hearing a lot about the Supreme Court's decision on the constitutionality of the Affordable Care Act (ACA). The discussions began in late March when the Supreme Court heard arguments focused on whether the individual mandate and the expansion of Medicaid were constitutional. The mandate would force most Americans to have health insurance starting in 2014, or pay a penalty – a requirement that some felt was too big an extension of the federal government.

The mandate question also raised a separate issue for the Court: if the mandate was ruled unconstitutional, would other provisions of the ACA have to be struck down as well?

Ruling: On June 28, the Supreme Court voted 5-4 to uphold the individual mandate. The Court also found the Medicaid expansion constitutional, but specified some limitations. Chief Justice Roberts sided with the more liberal justices of the Court and voted to uphold the mandate, stating the law was “authorized by Congress's power to levy taxes,” as such the penalty for not purchasing insurance acted as a tax. In regards to Medicaid expansion, the majority of the Court held that it would be unconstitutional for the federal government to withhold all Medicaid funding from states that choose not to expand their Medicaid programs under the ACA. This means that States can choose not to comply with the new ACA requirements, while maintaining their current Medicaid funding. However, if a state chooses not to expand its program, that state will not have access to any of the new funding for Medicaid expansion that is made available under the law.

What it means for you: The decision to uphold the constitutionality of the health reform law ensures that people living with spinal cord injury and paralysis will continue to benefit from provisions of the ACA, including: coverage of pre-existing conditions, removal of lifetime and annual benefit caps, a recognition of essential benefit categories that improve the ability of people living with disabilities and chronic conditions to maintain and improve their functional ability, and an expansion of home and community based services through state Medicaid programs.

As the country moves forward towards full implementation of the Affordable Care Act, we will continue to update you on the law's impact on people living with spinal cord injury and paralysis, and will continue the important work of ensuring that the law's implementation takes into account the unique health care needs of our community.

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Continue Christopher Reeve's LegacyPhoto by Timothy Greenfield-Sanders