So I’m left at a complete loss this week as yet another portion of the ACA is brought into question, but I’m not tongue tied for the reason that many would suspect. Since this blog is relatively young, I’ll enlighten any unfamiliar readers to the fact that I’m a strong supporter of socialized medicine personally. I don’t think ACA nailed it, but I was just thrilled that we were one step closer to reconstructing what health care means through massive reforms. My hope was (and remains) that a larger pool of insured Americans would result in stronger leverage for bringing down health care costs, better transparency on where our healthcare dollars are going, and greater equality in accessing health needs.
Sadly, this week was another hit for the third item as equality again comes into question. After many states opted not to participate in the Medicaid expansion, leaving some of their most vulnerable residents unsupported, there is now tension over when and how subsidies should be made available only for health plans established by the state or whether whether federal plans are eligible for subsidies as well. Payroll provider, ADP, provided a nice overview in their article Supreme Court Bound? Circuit Courts Split on Important ACA Provision:
The United States Court of Appeals for the District of Columbia (the D.C. Circuit) agreed with the plaintiffs and ruled subsidies are only available for coverage purchased on State Exchanges. The United States Circuit Court for the Fourth Circuit (the 4th Circuit) upheld the interpretation advanced by the IRS by deciding that subsidies are available to individuals whether they purchase coverage through a State or Federal Exchange. If this appellate court split remains, there is a high likelihood that the U.S. Supreme Court would review this matter and issue an opinion resolving conflicting decisions by the end of its next term in July 2015.
One obvious issue is that many states declined to create state-based exchanges, relying instead on the federal exchange to cover their residents.
Yet again we find that the citizens left most vulnerable to lack of health care are those that need the support the most. And I grow one step closer to applying for Swedish citizenship. My husband could always change his name to Sven…he looks like Sven.
Blogging for my health 