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Health News Florida

Healthcare Law Expert Breaks Down "Decision of the Century."


The Supreme Court's decision on whether to uphold the Affordable Care Act is being called the "decision of the century." 

It's expected to be announced tomorrow whether the high court will uphold the law,throw it out, or discard parts of it.

Jay Wolfson is an expert in healthcare law at the University of South Florida and Stetson University. 

"The largest issue before the court is actually the mandate which is a requirement that all Americans demonstrate that they have coverage of some sort," Wolfson says. 

"That's something we currently do not require. If the mandate is upheld then all of us are going to have to find a way to purchase-or become eligible to participate in a health insurance program."

If the law is thrown out, Wolfson has this prediction.

"There's going to be a scramble within Congress within the executive branch of government of this next year. It will be a tremendous hit if it's thrown out completely to President Obama's campaign.”

The current law contains several provisions that will no longer exist if the law is discarded completely.

Wolfson says, “The other components are what I call the categoricals."

" These are things like permitting children 26 years of age and younger to remain on the family plan, requiring community ratings as opposed to individual ratings, doing away with pre-existing condition requirements for eligibility so if you happen to have something that's a disease disorder or disability you will not be denied coverage because of it. Also, stopping terminations by insurance companies of people who use large amounts of benefits because of their health conditions."

He says one issue in particular will affect older Floridians if the law is thrown out completely.

"A very, very important issue for Floridians is the donut hole for the Medicare prescription drug program,"Wolfson says.

 "It was originally designed creating a huge financial gap so that Medicare would pay for a certain dollar amount and then it would stop and then citizens of Florida who were Medicare eligible would have to pay a couple thousand dollars out of their pocket before Medicare drug benefits would kick in again."

If the law is upheld, Florida will face a significant challenge.

"Florida is going to be particularly affected because of the large Medicaid population we have. One of the proposals in the new law is that the standards be expanded so that people who are currently not eligible would be eligible, Wolfson says.

That would bring about 1.5 to 2 million new people into the Medicaid program. Florida would have to pay for part of that.

Wolfson says no matter what the court decides, health care in the United States still has a long way to go.

"It's the reform of the guts of the system, the American health care system which has gone far awry. It costs too much, does too little, does a lot of the wrong things. It intervenes in ways that makes people sicker then they were. Only if there is some trauma we do ok, the rest of the time, we suck."

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