On June 28, 2012 the Supreme Court announced its decision on the health care law, which upheld the constitutionality of the individual mandate and allowed states to opt-out of Medicaid expansion. The Congressional Budget Office (CBO) recently released an updated budget estimate to reflect changes in the insurance coverage provision of the ACA resulting from the Supreme Court’s decision.

While SCOTUS upheld the constitutionality of the ACA’s individual mandate that requires people to purchase insurance or pay a penalty tax, this is not the reason why the CBO revised its budget estimate. The update was necessary to reflect projections stemming from the SCOTUS decision that fewer people will be covered by Medicaid and CHIP (6 million), and more people will be enrolled in and exchanges (2 million) and uninsured (4 million) than their previous estimate. As a result of these changes, CBO estimates net costs will be $84 billion less than originally projected.

 

CBO Budget Estimates for(2012 – 2022) Net Costs (billions)
March  2012 $1,252
July 2012 – Post SCOTUS update $1,168
Savings $84

 

Changes In Insurance Coverage (millions)

March 2012 July 2012 Difference
Medicaid & CHIP

13

7

-6

Exchanges

8

9

+2

Uninsured

-18

-14

+4

Numbers may not add up to totals because of rounding.

Read the entire CBO report.

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.

We surveyed seniors on Medicare to learn how they feel about the Supreme Court and its recent ruling on the health care law. The results are very interesting, and we hope you’ll enjoy reading about it in the press release below. Thanks!

July 17, 2012 03:00 PM Eastern Daylight Time

Extend Health Survey: Seniors on Medicare Respond to U.S. Supreme Court Decision on Healthcare Reform Law: 46% of Senior Women View the Decision as “Positive”; 27% of Senior Men

Survey fielded within 24 hours of ruling reveals “gender divide” among seniors

SAN MATEO, Calif.–(BUSINESS WIRE)–A survey of 441 seniors on Medicare fielded from June 29-July 2, 2012, showed that 46% of female respondents view the U.S. Supreme Court ruling upholding the constitutionality of the healthcare reform law as “positive,” compared with just 27% of male respondents. In addition, 40% of senior women said that the fact that the ruling upheld provisions closing the Part D prescription drug coverage gap, known as the “donut hole,” influenced how they felt about the ruling, compared to just 26% of senior men who felt similarly.

The survey was fielded by Extend Health, operator of the nation’s largest private Medicare exchange. The company has been surveying seniors on their attitudes about retirement, healthcare and Medicare since December 2009. Extend Health is a Towers Watson company.

Under the healthcare reform law, individuals who fall into the donut hole receive a 50% discount on the cost of brand-name prescription drugs, with that discount increasing in future years until it reaches 75% in 2020. If the Supreme Court had ruled the law unconstitutional, that provision would have been overturned.

Said Bryce Williams, Managing Director of Extend Health, “The healthcare reform law is a divisive issue for many Americans, but seniors on Medicare apparently line up along gender lines. Based on comments made by our survey respondents, the reason for the different views of women versus men is based in part on women’s experience as caregivers to multiple generations: their children, their parents and their spouses. Perhaps this accounts for the difference in how women view the healthcare reform law and its goal of insuring more Americans.”

Questions and detailed results from the survey are as follows:

On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act, with some clarifications. All of the provisions of the law that affect Medicare remain unchanged.

What do you think about the Supreme Court ruling overall?

Men Women
I think it is positive 27.3% 46.1%
I think it is negative 61.7% 38.3%
I don’t have an opinion 11.0% 15.7%

Under the Affordable Care Act, individuals who fall into the Part D coverage gap (“donut hole”) receive a 50% discount on the cost of brand-name prescription drugs, with that discount increasing in future years until it reaches 75% in 2020. If the Supreme Court had ruled the law unconstitutional, that provision would have been overturned.

How does the fact that the Part D coverage gap provision was upheld influence how you feel about the ruling?

Men Women
I feel more positive 25.7% 39.7%
I feel more negative 19.9% 17.2%
It makes no difference 54.4% 43.1%

Extend Health has helped hundreds of thousands of seniors compare and choose private Medicare plans. Extend Health is the only place seniors can compare thousands of plans from more than 75 carriers side by side and find plans that best meet their needs. Licensed benefit advisors are available to help seniors evaluate their Medicare coverage and explore new options quickly and easily.

About Extend Health

Founded in 2004, Extend Health operates the largest private Medicare exchange in the country. Extend Health is a Towers Watson company. For more information, visit Extend Health on the web at http://www.extendhealth.com.

Extend Health is a registered trademark of Extend Health, Inc. Other names may be trademarks or servicemarks of their respective owners.

Contacts

For Extend Health, Inc.
Rob Wyse, 212-920-1470
rob@WT221.com

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.

Here’s and excerpt from a new post just published on Bryce Williams’ blog “Watch This,” about today’s ruling by the Supreme Court on the ACA:

“With Chief Justice Roberts siding with the majority, the Supreme Court decided in a 5-4 vote to uphold the individual mandate as a tax. The case before the court on Medicaid expansion was upheld narrowly, with the Court ruling that the federal government may not cut off all of the Medicaid funding of states that opt out of Medicaid expansion . . .”

Read the full post on Watch This.

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare insurance exchange.

Key Takeaway from Today: 

The constitutionality of the individual mandate seems up in the air after tough questions from the bench.

What Happened:

Today the Court heard oral arguments on the constitutionality of the individual mandate (IM).  The Solicitor General (SG), arguing on behalf of the Obama Administration, was faced with a barrage of questions from four of the Justices (Kennedy, Roberts, Alito, Scalia), while the fifth (Thomas) did not ask a question but is widely expected to vote against the constitutionality of the mandate.   Their questions aimed at establishing whether there are any limiting principles that apply to the mandate to purchase health insurance.  In other words, if the Court were to declare the mandate is constitutional, would they be setting a precedent that an individual mandate for any product is also constitutional, or are there aspects of health insurance that make it special in the eyes of the constitution?  The SG’s response, over and over again, was that health insurance is different than other products.

The question of whether health insurance was meaningfully “different” from other products continued to be debated during the challengers’ oral arguments.  The questions of four justices (Kagan, Sotomayor, Ginsburg, and Breyer) seemed to suggest they agreed with the argument the Solicitor General had put forth.  Despite his earlier questions, Justice Kennedy, who is often the swing vote when the court votes 5-4, left room for the possibility that health care is, in fact, different than other products:  “…And the government tells us that’s because the insurance market is unique. And in the next case, it’ll say the next market is unique. But I think it is true that if most questions in life are matters of degree, in the insurance and health care world, both markets — stipulate two markets — the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries.  That’s my concern in the case.”

Oral arguments often but not always signal where a Supreme Court justice is on a given issue.  But many commentators today suggested the challengers presented the more effective argument.

For a more detailed recap of the day’s events, go here.

And for an interesting perspective on whether insurance is different than other products, read this post on Robert Toth’s Business of Benefits blog.

John Barkett

Director, Extend Health, Inc. and former HHS analyst
Extend Health, Inc.

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare exchange.

Key Takeaway from Today:

The Supreme Court is likely to decide on the constitutionality of the law this June.

What Happened:

Today the Court heard arguments from three parties on whether the Anti-Injunction Act (AIA) applies to challengers of the individual mandate. The AIA prohibits parties from bringing forth a lawsuit that challenges a tax before the tax has actually been assessed. The Court appointed a third party lawyer to argue the case for the AIA’s application, as neither the Justice Department nor law’s challengers (26 states, the National Federation of Independent Businesses, and various independent parties) were willing to argue that the mandate’s penalty is a tax.

The overwhelming consensus among commentators today was that the Justices were skeptical that the penalty should be considered a tax. In other words, the road has been cleared for the justices to decide on the individual mandate’s constitutionality. For a longer-but-still-in-plain-English write-up on the day’s activities, see here: http://www.scotusblog.com/2012/03/anti-injunction-act-oral-argument-in-plain-english/

For a 15 minute audio play-by-play, see here: http://www.scotusblog.com/2012/03/we-listen-to-the-whole-aia-argument-so-you-dont-have-to/

I’ll be back tomorrow with an update on the day’s SCOTUS activities.

John Barkett
Director, Extend Health, Inc. and former HHS analyst
Extend Health, Inc.

Visit Extend Health to use the ExtendExchange™ platform – the nation’s largest private Medicare exchange.