On Monday, the U.S. Supreme Court announced that it will review the legal challenges against the federal health reform law, the Affordable Care Act (ACA), in early spring 2012. While several different lawsuits challenging the law were presented to the justices, the court will only review the multistate lawsuit filed by 26 states and the National Federation of Independent Business.
Although the ACA provisions that affect Medicare have not been challenged, the discord over the law casts uncertainty over the stability of new Medicare benefits and beneficiary protections provided by the new law. The issues the Supreme Court will consider are:
- Whether the controversial individual mandate is severable from the rest of the law or if the whole law, including the Medicare provisions, must be overturned if one provision is found unconstitutional;
- Whether Congress may require states to expand their Medicaid programs by withholding funds from states if they do not;
- Whether Congress was acting within its power to require Americans to buy health insurance or pay a penalty; and
- Whether parties have legal standing to challenge the individual mandate requiring health coverage since that provision is not yet in effect.
“Many Medicare beneficiaries have already benefited from the Medicare provisions in the ACA,” said Elaine Wong Eakin, Executive Director of California Health Advocates. “These new Medicare benefits were hard-won, and it would be a shame to lose them should the Supreme Court find the whole law unconstitutional because of one provision.” The Medicare improvements include discounts for beneficiaries in the Part D prescription drug “donut hole,” better access to preventive services, and an annual out-of-pocket cap for beneficiaries in Medicare Advantage plans. Furthermore, the ACA incorporated cost-savings to sustain the Medicare program, and these cost-savings would be lost should the whole law be overturned.
Even if the Supreme Court upholds the ACA, the Medicare program is targeted for cuts. “As lawmakers find ways to cut the federal deficit, they should pay more attention to the cost-saving measures in the ACA,” recommended Wong Eakin. The ACA introduced initiatives to control costs as well as improve care that results in better health outcomes for the population. Instead of focusing on cutting Medicare benefits and increasing beneficiary out-of-pocket costs, lawmakers should build on the ACA initiatives.