The Affordable Care Act’s Day(s) in Court

The Supreme Court heard arguments about the Obama Administration’s Affordable Care Act earlier this spring, and is expected to hand down a decision regarding the healthcare law any day now. Here’s a look at how various possible decisions could affect the state of healthcare in the United States.

Option 1: The Supreme Court Rules the Affordable Care Act Is Good to Go

The main argument against the Affordable Care Act challenges its so-called individual mandate, which, if enacted, would require all Americans to have health insurance (through the government, employers, or an individually purchased plan). If the individual mandate is given the green light, then…

  • Uninsured Americans will have to purchase health insurance by a certain deadline or face a penalty charged at tax time.
  • Health insurance companies will be required to make insurance coverage available to everyone, including those with preexisting conditions.
  • Low-income Americans (those with household incomes up to 138% of the poverty line) will qualify for government assistance for medical insurance (possibly in the form of Medicaid).

The individual mandate could be good news for women with breast cancer who have been denied coverage or reimbursement for treatment, because it will require insurers to cover them regardless of their current or former health.

But most health professionals, regardless of their political affiliation, agree that the individual mandate is far from an ideal system.

Option 2: The Supreme Court Strikes Down the Individual Mandate

If the Supreme Court rules that the individual mandate is unconstitutional, the Affordable Care Act may be doomed. Without the guarantee that all Americans buy health coverage, there is no incentive for health insurance providers to make coverage available to those with breast cancer and other potentially costly conditions.

Without the individual mandate, the health insurance landscape in the U.S. may remain as it is for the immediately foreseeable future.

More Reasonable Healthcare Down the Road?

Some commentators on the health care hearings have suggested that there might be greener pastures ahead for health insurance in the States. It seems that a dismissal of the individual mandate could, by some analyses, pave the way to a single-payer insurance system, under which all Americans would be covered by the federal government, regardless of job or health status.

While most Americans agree that the current state of health insurance in this country is far from ideal, few understand how important comprehensive coverage is better than those who have had life altering illnesses like breast cancer and major procedures such as breast reconstruction.