You’ve probably heard by now that the 2010 healthcare law was largely upheld by the Supreme Court on Thursday.
Even though polls indicate that public opinion about the Affordable Care Act (ACA) has been steady, many of us following the fate of the ACA were expecting that the law was strongly disfavored after oral arguments and subsequent media coverage. Thursday’s decision of the court to uphold the individual mandate to purchase health insurance as a tax came as a surprise to many of us. The initial confusion about the ruling was the result of the Court’s ruling on which part of the Constitution applied. In the opinion, Roberts says that the mandate fails as a regulation of commerce and draws a clear boundary around the Commerce Clause, the piece of constitutional authority heavily relied upon in briefs and arguments back in March.
Just because the Court approved the law does not mean the work is done. Last week’s ruling limits the ACA’s proposed expansion of Medicaid. Texas can now choose whether or not to expand Medicaid coverage to millions more low-income individuals. If it does, the federal government pays 100 percent of the extra cost for 2014, 2015 and 2016 and gradually reduces its coverage to 90 percent of the extra cost in 2020 and each year thereafter. Texas Health and Human Services executive commissioner Tom Suehs has already released a statement indicating some hesitancy to pursue full expansion.
There will be plenty to do in the coming months to help the state develop a mental health system that promotes wellness and recovery for all Texans living with mental illness. For now, people seeking greater access to vital mental health services can take comfort in the fact that important reforms are on track to take effect in 2014.