Supreme Court Upholds Health Care Reform

Supreme Court Upholds Health Care Reform

With the deciding vote of Chief Justice John Roberts Jr., the Supreme Court upholds the historic health care reform law, the Affordable Care Act. This means that all the Medicare provisions giving beneficiaries enhanced benefits WILL stay intact and the law, for the most part, will continue to roll out as planned.

Summarized below are some of the specific benefits that Medicare beneficiaries will continue to enjoy with the Supreme Court’s decision:

  • Medicare beneficiaries will continue to save on prescription drug costs as the Part D “coverage gap” or “donut hole” gradually closes until it is eliminated in 2020. Due to this change and the 50% discount on brand name drugs Medicare beneficiaries currently receive while in the coverage gap, nearly four million beneficiaries have saved more than $2.1 billion on prescription drugs in the past year alone.
  • Medicare beneficiaries will continue to receive many preventive services without paying a deductible or coinsurance. Since January of this year, over 14 million beneficiaries have received at least one preventive service without cost-sharing, according to a recent announcement from the Centers for Medicare and Medicaid Services (CMS).  In California, that number is 1,180,220 beneficiaries.
  • Medicare beneficiaries will continue to have access to several new preventive health benefits, including: an Annual Wellness Visit; screening and counseling for alcohol misuse, obesity, smoking cessation, and sexually transmitted infections; counseling to reduce the risk of cardiovascular disease and screening for depression.

Some additional benefits that affect a broader spectrum of the population include:

  • People will continue to get coverage through the federally funded Pre-Existing Condition Insurance Program (PCIP). Currently 55,000 people nationwide, over 11,000 of who are in California, who had been denied coverage for pre-existing conditions now have coverage through the PCIP.
  • Millions more people will be able to qualify for health coverage through their state’s Medicaid program. In California, over 400,000 low-income residents who are not otherwise qualified for Medi-Cal (California’s Medicaid program), now have coverage through county-run, federally matched Low-Income Healthy Programs, and will have Medi-Cal coverage in 2014.
  • Young adults age 26 and under will continue to receive coverage through their parents’ insurance. Currently 2.5 million young adults (which include over 350,000 in California) are receiving such coverage.

In addition, the Supreme Court’s decision authorizes federal funding both to expand Medi-Cal to 2 million Californians living at or near poverty in 2014, and to provide tax credits and subsidies that will allow more people to better afford health insurance coverage through the new Exchange markets.

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Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.