Updated March 26 at 12:25pm

Supreme Court upholds health care reform law


(Updated, 11:04 a.m.)

WASHINGTON – The U.S. Supreme Court issued its much-anticipated ruling this morning on the Patient Protection and Affordable Care Act, upholding the law, saying in a 5-4 decision that the law, with its mandate requiring health insurance coverage, was constitutional under the Congress’s taxing authority, not the Interstate Commerce clause.

The majority opinion, written by Chief Justice John G. Roberts, found that Congress had the constitutional authority because failure to comply with the individual mandate would be a tax penalty. As a result, people don’t have to get health insurance, but they will be required to pay a tax.

At the same time, the Supreme Court ruled that while the Medicaid expansion to broaden coverage was constitutional, it held that the “all or nothing rule,” which required states to participate in the expansion of coverage or lose their Medicaid funds, was not constitutional. The court ruled that states have the ability to opt out of the expanded coverage, which puts pressure on Congress to provide additional funds for the expansion.

The ruling upholds all the other reforms under the law.

“By upholding the law, the court validated the principle that all Americans should have access to health care,” said Sen. Sheldon Whitehouse. “Seniors will continue receiving discounts on prescription drugs, children can continue to stay on their parents’ health insurance policy after college, and individuals suffering from chronic illness won’t need to worry about running into lifetime caps.”

“Today the United States Supreme Court affirmed the legality of the Patient Protection and Affordable Care Act,” said Edward Quinlan, president of the Hospital Association of Rhode Island. “This is an important decision for our state’s hospitals and patients. More than 120,000 Rhode Islanders currently lack health insurance. Each day, nearly 150 patients seek care in our hospitals without the ability to pay. The cost of uncompensated care exceeded $160 million last year and has become a monumental fiscal burden for our struggling hospitals. The Affordable Care Act will help to alleviate these challenges and ensure that every Rhode Islander has access to quality health care.”

R.I. Health Insurance Commissioner Christopher F. Koller, who was outside the Supreme Court in Washington, D.C., when the decision was announced today, described the scene as “historic.” As a result of the decision upholding the health care reform law, Koller said the “commercial health insurance market will function much better with an individual mandate, with healthy people as well as sick people in the market.” Koller anticipated that there would be continuing discussions regarding what is the appropriate tax penalty for people who don’t buy health insurance.


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Chris Koller along with Governor Roberts, have put Rhode Island at the head of the pack in implementation. This will create jobs for Rhode Islanders as other states look to us for implementation assistance. Thanks to Chris and Deb.

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