The eagerly-awaited and often speculated upon Supreme Court decision on the President’s signature achievement, the Affordable Care Act (ACA), has reignited a firestorm of debate throughout the country. Fundamental issues such as the role of government in health care, the alleged changing of Chief Justice Roberts’ ideological stripes, and the ramifications for the Presidential election have dominated the discussion.
Lost in the furor is what this means for bakers, other businesses and consumers of health care services. One thing is crystal clear from the decision – the Supreme Court agreed with the Obama Administration’s court arguments that the ACA mandate is a tax and therefore not covered by the commerce clause in the Constitution. The public protestations by the President and his aides notwithstanding, the majority of Americans accurately view ACA as a collection of tax increases.
Something else is clear, absent action by an evenly and deeply divided Congress – the 2,700 pages of prescriptive regulations will continue to be implemented this fall. Not all of these provisions are objectionable, items such as increasing the dependent coverage age to 26, coverage of wellness services, or eliminating exclusions for pre-existing conditions garner widespread, bi-partisan support. However popular though, they will add additional cost to health insurance.
While the House recently voted again to repeal ACA, Senate Majority Leader Reid (D-NV) has no intention of bringing repeal or reform legislation to a vote. In the next 18 months, several important provisions of ACA are phased in. Notably, taxes assessed to health plans, including self-insured plans, the elimination of the Medicare Part D deduction, further limitations on Flexible Spending Accounts, and significantly higher taxes on individuals. 2014 will bring a flurry of new requirements including the individual and employer mandates.
While the Washington chattering class is consumed with talk about “repeal and replace,” it is important to remember that for over a decade, ABA and other business groups have pushed for responsible changes to health care focused on reducing costs, expanding coverage options for smaller bakers and tackling runaway litigation costs. Nothing about the Supreme Court’s decision changes that dynamic and Congress needs to be prepared for the “replace” should it have the opportunity next year.
One final piece of clarity from the Supreme Court’s affirmation of ACA is that any fundamental change or even repeal will require a change in administration and Senate Majority Leader. The stakes in an already important election were ratcheted up a few more notches.
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Source: American Bakers Association