06/28/2012

Supreme Court Upholds the Individual Mandate in the Healthcare Reform Law

The Supreme Court ruled this morning that the individual mandate, requiring people to purchase health insurance under the Affordable Care Act, is constitutional. The individual mandate is a key component of the healthcare reform law.

As we reported earlier this week, the Supreme Court looked at four questions stemming from challenges to the Affordable Care Act.

• Should the court decide the case now or wait until 2015 when all of its provisions - including the individual mandate - have gone into effect?
• Is the provision that requires nearly all Americans to have health insurance (the individual mandate) constitutional?
• Can the law expand Medicaid, adding 17 million people to that program?
• If a part of the law is unconstitutional, can it be separated out or must the entire law be invalidated?

USA Today reports that, "The Supreme Court upheld the health care law today in a splintered, complex opinion that appears to give President Obama a major victory.  Basically, the justices said that the individual mandate -- the requirement that most Americans buy health insurance or pay a fine -- is constitutional as a tax." 

This means that the provisions in the Affordable Care Act that affect home medical equipment (HME) providers and their patients remain in the law. Specifically:

Acceleration in the geographic scope of the competitive bidding program in Round Two by including an additional 21 areas across the country:

Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
Washington-Arlington-Alexandria, DC-VA-MD-WV
Boston-Cambridge-Quincy, MA-NH
Phoenix-Mesa-Scottsdale, AZ
Seattle-Tacoma-Bellevue, WA
St. Louis, MO-IL
Baltimore-Towson, MD
Portland-Vancouver-Beaverton, OR-WA
Providence-New Bedford-Fall River, RI-MA
Buffalo-Niagara Falls, NY
Rochester, NY
Tucson, AZ    
Honolulu, HI
Albany-Schenectady-Troy, NY
Worcester, MA
Oxnard-Thousand Oaks-Ventura, CA
Springfield, MA
Bradenton-Sarasota-Venice, FL
Poughkeepsie-Newburgh-Middletown, NY
Stockton, CA
Boise City-Nampa, ID
 
Requirement that competitive bid pricing be applied nationwide as early as 2015 but by 2016;
 
Elimination of the two percentage point fee schedule increase for bidded items in 2014;
 
Elimination of the first-month purchase option for all power wheelchairs, except for complex rehab power chairs;
 
Mandatory face-to-face requirement for all HME items;
 
Application of a productivity adjustment to the HME fee schedule payments not subject to bidding; and,
 
Tax on medical devices.