People love making predictions. Foretelling the Supreme Court’s decision on the constitutionality of the individual mandate in the Patient Protection and Affordable Care Act (ACA) is no exception.
If you relied on CNN’s legal analyst Jeffrey Toobin’s assessment of the case just after oral arguments back in March, most likely you’ve predicted the entire law is going down. Toobin said the arguments were “a train wreck for the Obama administration” and that the law could be in “grave trouble.”
Or take a look at the predictions on FantasySCOTUS.net where 54% say the individual mandate is unconstitutional.
Further, InTrade indicates there’s a 61% chance the Court will rule the mandate unconstitutional before December 31, 2012. You can even buy or sell “shares” based on whether or not you think this event will occur. (That’s a bit disturbing to me, but like I said, people love making predictions, and they really love the possibility of making money off those predictions. Never mind the possibility of losing money!)
But others have a more tempered approach. “While predictions about what the Court will decide are highly sought after, they are generally meaningless. The Court will make a decision this term, probably in June, and we will move forward after that point,” Kathryn Bakich, Senior Vice President and National Health Compliance Practice Leader at The Segal Company, said in an interview with Wolters Kluwer.
Bakich continued, “Nevertheless, many commentators predict a six-to-three vote in favor of the mandate, with Chief Justice Roberts joining a five-member majority consisting of Justices Kagan, Breyer, Sotomayor and Ginsberg plus Justice Kennedy. Justice Kennedy’s vote is key to sustaining the validity of the mandate, but his questions during oral argument did not give comfort to supporters of the mandate, as he sharply criticized the government’s points and indicated he was looking for a principle by which to limit the government’s authority to regulate commerce.”
No matter which way you think the court will rule (please comment on this post and let’s discuss it!), a lot of work continues on implementing the law as we continue to wait for the Court’s decision (expected in late June). In the meantime, if you insist on making predictions on this or any other future event, I have a Magic 8 Ball you can borrow.
Wednesday, May 30, 2012
Monday, May 28, 2012
Happy Memorial Day!
In honor of Memorial Day, Health Reform Talk will take a short break.
The National Moment of Remembrance encourages all Americans to pause wherever they are at 3 p.m. local time on Memorial Day for a minute of silence to remember and honor those who have died in service to the nation.
Friday, May 25, 2012
Health Reform’s Temporary High-Risk Pool Open For Business
Nearly 62,000 individuals nationwide had enrolled in the Pre-Existing Condition Insurance Plan (PCIP), the temporary high risk health insurance pool established under the Patient Protection and Affordable Care Act, in the first quarter of 2012, the Center For Consumer Information and Insurance Oversight (CCIIO) reported.
These numbers are not as impressive as supporters hoped they would be, however-- 5 million persons had been expected to enroll in the $5 billion program. To help more individuals with preexisting conditions sign up for the program, last year, the CCIIO reduced premiums in the PCIP by as much as 40 percent in 18 states and eased eligibility standards in the 23 states and the District of Columbia where the federal government administers the PCIP.
The PCIP is designed to provide health insurance coverage for individuals who have been uninsured for six months and who have been denied a policy because they have preexisting conditions, including employees in companies that do not provide health coverage. The program is administered by either the state or the federal government and 27 states have elected to administer their own. In the 23 and the District of Columbia states where the federal government runs the program, enrollment applications began to be accepted on July 1, 2010, with coverage beginning Aug. 1, 2010, at the earliest. The pool will run until Jan. 1, 2014, when state-based Affordable Insurance Exchanges are scheduled to begin operation.
Massachusetts and Vermont are guarantee issue states that have already implemented many of the broader market reforms included in the Affordable Care Act that take effect in 2014. Existing commercial plans offering guaranteed coverage at premiums comparable to PCIP are already available in both states, the CCIIO explained.
Premium costs and the six-month waiting period likely are obstacles to increased PCIP enrollment. For example, in Illinois, a state that runs its own PCIP, the following options are available:
Premium: $76 to $693 for a non-smoker, rates vary by region
Deductible: $500, $1000, $2,000, and $5,000
Out of Pocket Limit: $2,850 to $5,000 for medical depending on plan option, $0 to $1,600 for pharmacy depending on plan option, with a maximum out-of-pocket limit from $5,000 to $5,950 depending on plan option
The federal government’s HealthCare.gov website has a helpful feature that allows individuals to search for insurance options in their state and lists options for affordable health care services regardless of insurance-status. Awareness-raising would help.
