EXAM 3 SYS* – Affordable Care Act 2 – Flashcards

3 major cases 1. NFIB National Federation Independent Business v Sebelius - individual mandate was allowed, Medicaid Expansion upheld and upheld but limited 2. Hobby Lobby - contraception, religiously owned exempt from contraception mandate 3. King v Burwell - subsidies for state-exchanges, bad wording meant for all exchanges

• Question 1 - is the Individual Mandate constitutional? Yes. Does gov have power to make you buy insurance. • Question 2 - Was Medicaid Expansion legal? Can federal gov requires states to expand Medicaid? - No, so it's voluntary.

CONGRESS HAS THE POWER TO REGULATE COMMERCE • Once you choose to do something, federal gov can regulate you • Federal gov can regulate commerce between states • as the reason that a lot of people thought the individual mandate would not be upheld- many argued that health insurance did not fall under the commerce clause so it was not legal. Instead the supreme court ruled it was a tax- to get around the commerce clause problem.

the government has the power to tax, and can say do this and you will be taxed. If you don't purchase insurance, you pay tax. • But they didn't call it a tax, they called it a penalty.

court said it wasn't constitutional to have a penalty, so called it a tax. (based on commerce clause)

can't make every state expand, voluntary • States have to cover a new population or get funding taken away

RULING - RELIGIOUS COMPANIES CAN'T BE FORCED TO COVER FEMALE CONTRACEPTION. Hobby Lobby craft store contraception use. Owned by religious family, mandate that they had to provide everyone wit insurance with requirement of minimum benefits. Didn't believe in contraception, didn't want to provide to employees. • Question - can a corporation have religious beliefs? - not forced to pay for • Religious Freedom Restoration Act • Burwell - Secretary of HHS

• Question - who is eligible for subsidies?

Majority in the market place receive subsidies

congress meant to offer subsidies to everyone but bad wording.

• Decrease in uninsured • Affordable for some • Market competition drives price down • Better than before, not fantastic • Not sure about health outcomes • Readmissions have gone down since penalty

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11.4 million signed up for private health insurance

most signups in Florida

Positive on access, negative on cost