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Supreme Court Upholds Affordable Care Act

Published July 12, 2012


Horizons in Hemophilia, July 2012

By Michelle Putnam, Associate Director of Advocacy and Research

People with hemophilia have always acted as advocates for their own health care. Whether talking with a physician, an insurance agent, or a legislator, members of the bleeding disorder community have been ready to show how meaningful health coverage is to them. The Affordable Care Act made this task easier. The health law stops insurance companies from denying coverage for children with pre-existing conditions and establishes a high-risk insurance program for uninsured adults. It bans the practice of lifetime caps. It allows young adults to stay on their parents’ insurance until the age of 26.

In order to accomplish these goals, the law requires one thing: that everyone who can afford to should buy health insurance. If only people with chronic conditions buy insurance, and all the healthy people opt out, this will drive up prices and premiums for those of us who need coverage. This requirement, known as the individual mandate, was one of the most hotly contested parts of the Affordable Care Act and one of the reasons it ended up being heard by the Supreme Court this year. In addition, the Republican governors who led the charge against the law said that the federal government could not require them to expand their Medicaid programs to uninsured adults.

The Supreme Court heard arguments on this case in March. On June 28, the last day of its 2012 term, the Court determined that the individual mandate, and thus the rest of the Affordable Care Act, is constitutional and can continue to be implemented with a minor adjustment to the Medicaid provision. As a result, we will not only continue benefitting from the parts of the law that have already gone into effect, but we will also enjoy even more meaningful coverage as more provisions roll out.

In 2014, insurance companies will no longer be able to deny coverage for adults due to pre-existing conditions and they will not be able to impose annual dollar limits on coverage. In addition, women will not be charged more for health insurance simply because of their gender. Seniors will continue to save hundreds of dollars on prescription drugs. Small businesses will receive tax credits to help their employees purchase insurance. Purchasing insurance will be easier through an online marketplace exchange, where you will be able to compare insurance policies in an easy manner. And those who cannot afford health coverage will receive a tax credit to help pay for it.

In 2014, the law also says that states should expand their Medicaid programs to cover poor adults who make less than $15,000 a year. For the first three years the federal government will cover the entire cost of this expansion and will then gradually reduce its contribution to ninety percent. This is a good deal for Georgia and will bring in billions of dollars to the state at a minimal cost. The Supreme Court decision gives states the option to participate in this expansion, but many Republican governors have said they will not consider the option due to their opposition of the law as a whole.

Leading up to November, politicians will use the health care law as a messaging point. Governor Deal has steadfastly voiced his opposition to the health care law and in a recent press conference called for its repeal after the November elections. As we go forward it is important that people with chronic and expensive conditions not go back to the days before 2010.  Before 2010 people with chronic conditions were dropped from coverage or denied altogether, our young adults spent more time searching for affordable coverage rather than focusing on academic success, and our entrepreneurs shelved their small business ideas because they needed to work for large companies to get insurance coverage.

Thanks to the Supreme Court decision, we can rest easier, but it is important that we don't take this law for granted and that our elected officials realize how much it means to our community. If you would like to share your story about how the health care law has helped you, please contact Michelle Putnam at