On June 28th, the United States Supreme Court issued its decision upholding the constitutionality of the federal Affordable Care Act (ACA). As a result of the decision the protections for children remain in effect:
- Insurers may not discriminate against children based on pre-existing health conditions; insurers cannot impose life-time caps on insurance coverage.
- Funding for HUSKY B (the Children’s Health Insurance Program) remains in effect at least through September 30, 2015 and children’s income limits under HUSKY remain in effect until 2019.
- Young adults up to age 26 can stay on their parents’ employer-sponsored health insurance plans.
- In 2014, low-income adults with income up to 133% of the Federal Poverty Level will be able to gain coverage in Connecticut through the Medicaid program. Initially, the federal government will pay 100% of this Medicaid expansion, and over time the state will pick up at the most 10% of the cost of covering these adults. Under the Court’s decision, if a state opts out of expanding Medicaid to cover low-income adults, the federal government cannot withhold federal reimbursement for other parts of the state’s Medicaid program as the law intended. However, it seems unlikely that most states will pass up a chance to cover a large segment of the uninsured (almost half of those eligible for coverage were expected to gain it through the Medicaid expansion) when the federal government will be picking up the tab.
Now that the legality of the law is resolved Connecticut can continue to move forward on implementing health reform by, for example, establishing a health insurance exchange, by deciding whether to create a “basic health program” (as permitted under the ACA) run by the State but funded by the with federal dollars as a more affordable alternative to coverage through an exchange for certain low-income adults (with income between 133% and 200% FPL), continuing efforts to improve coordinated care in its HUSKY program, and instituting outreach and enrollment practices that ensure that families get on and stay on coverage programs.