The U.S. Supreme Court upholds the Medicaid expansion in the Affordable Care Act, protecting health care coverage for the people with the greatest financial needs.

The United States Supreme Court ruled today to uphold the Medicaid expansion in the Affordable Care Act, protecting health care coverage for the people with the greatest financial needs.  In National Federation of Independent Business v. Sebelius, the Court decided that the planned expansion of Medicaid eligibility to 133% of the federal poverty guidelines is constitutional.

Writing for the majority, Chief Justice John Roberts said, “Nothing in our opinion precludes Congress from offering funds under the Affordable Care Act to expand the availability of health care, and requiring that States accepting such funds comply with the conditions on their use.”  The ruling will impact an estimated 800,000 Pennsylvanians who may be newly eligible for Medicaid (called Medical Assistance in Pennsylvania) beginning January 1, 2014 if Pennsylvania decides to accept the 100% federally funded expansion.

“This is good news not only for those individuals who will be able to obtain Medicaid coverage beginning January 1, 2014 but it is also good news for Pennsylvania’s workforce, educational institutions, and health care entities” said Laval Miller-Wilson, Executive Director of the Pennsylvania Health Law Project.  The ruling affirms the constitutionality of the entire Act and allows Pennsylvania to move forward in implementing the provisions to assure access to health coverage for all.

“By covering people who were previously uninsured, Medicaid will provide preventive care and address unmet health care needs, improving health status for thousands who have gone without regular care.”

Should Pennsylvania decide not to expand Medicaid eligibility and reject billions in federal funds, it risks jeopardizing the health of its hospital systems, particularly in rural and urban communities.  Under the ACA, hospitals will lose 75% of payments previously used to support care for the indigent and uninsured, known as disproportionate share hospital (DSH) payments.  The expansion of Medicaid was designed to offset that loss by covering the lowest income uninsured.

While there are challenges ahead to enroll those newly eligible and to provide health care services, PHLP is optimistic that these challenges can be met and will work with state government, health care providers, consumers, and insurers to assure a smooth transition to coverage and access to care.

To read the Supreme Court decision, click here. 

For more information about Medicaid and Health Reform:
Kaiser Family Foundation
Georgetown Center for Children and Families

For press inquiries, please contact Ann Bacharach at (215) 625-3596 or abacharach@phlp.org.