The Affordable Care Act’s Two Futures

Author | Shield HealthCare
07/30/15  7:09 PM PST
Affordable Care Act

Original article authored by Anthony Wilson of California Healthline July 29, 2015

In the wake of the Supreme Court’s recent ruling in King v. Burwell and the high court’s earlier ruling upholding the constitutionality of the Affordable Care Act, many health policy experts said the law is more firmly “entrenched” than ever and will be around for years to come.

Meanwhile, the recent 50th anniversary of the nation’s other large health programs — Medicaid and Medicare — got us thinking about the future of the ACA. In those five decades, Medicaid and Medicare have gone through massive changes. So what changes will the ACA experience? Conversely, what must happen for the ACA to be repealed entirely?

Put on your guessing hats and let’s examine what the future holds for the health reform law.

Looking Ahead

The first step to predicting the future of the ACA is to acknowledge that it’s nearly impossible to predict the future of the ACA. In fact, some of the experts California Healthline invited to discuss possibilities for the law declined to do so, citing the complexity of the law and the continuing partisan debate over its existence.

That said, several experts were game to look into the future.

Tim Jost, a law professor at Washington & Lee University and an ACA expert, shared one near certainty: The ACA has set one precedent that is likely to continue to exist into the future. He said, “[T]he idea that people should have access to health care even if they can’t afford it is here to stay.”

However, Jost said some things are bound to change. He called the current insurance situation a “bizarre nonsystem,” in which “higher-income people get generous tax subsidies for employment-related coverage and low income people get tax credits but some middle income people get nothing.” He added that it is “unsustainable” and that the nation instead needs “a system where everyone gets the level of help they need for coverage and cost sharing but not more.”

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