U.S. Supreme Court Issues Ruling on PPACA

In its decision this morning, the U.S. Supreme Court appears to have upheld most of the Patient Protection and Affordable Care Act (PPACA). The individual mandate, which was at the center of debate surrounding PPACA appears to have been ruled constitutional not under the Commerce Clause, but under Congress’ powers to impose taxes. The court did provide a narrow interpretation pertaining to new eligibility requirements for states to comply with for Medicaid. The court ruled this provision was constitutional as long as states would only lose new Medicaid funds for not meeting requirements. States could not be denied all of their Medicaid funding for failing to meet the new guidelines.

With this decision, the focus in Michigan now shifts to state legislators, who had put legislation to bring Michigan into compliance with PPACA on hold until the Supreme Court issued its decision. Last fall, the Senate passed SB 693 (Marleau, R-Lake Orion), which would create a health insurance exchange in Michigan. This bill passed on a 25-12 vote in November 2011 and was referred to the House Health Policy Committee. The House committee held preliminary hearings at the start of 2012 but has not taken any action on the bill.

The Office of Financial & Insurance Regulation (OFIR) is continuing its work to develop Michigan’s Essential Health Benefit design. The public comment period for this remains open through tomorrow, June 29.

In a statement issued late Thursday morning, Governor Rick Snyder called the PPACA “legislation that misses the point on the most important reforms needed in our health care system.” He also derided the bill as a detriment to economic recovery and a cause for great “uncertainty” for medical costs, which discourages job creation.

The governor added that the “greatest health care opportunity” for Michigan citizens is prevention, citing his Michigan Health & Wellness 4×4 Plan as a starting point to reduce obesity and improve the state’s health outlook by focusing on healthy behavior and measures.

Full Text of Governor Rick Snyder’s Statement

With legislators on summer recess, the next scheduled session day is set for Wednesday, July 18. Only one session day is currently slated for each chamber in August (August 15 for the House, August 16 for the Senate). Both chambers are expected to return for regularly scheduled session on September 11.

House Speaker Jase Bolger (R-Marshall) issued his own statement that he “could not be more upset” by the ruling, but said the House will work with Governor Snyder and the Senate to protect Michigan residents. On the health insurance exchange legislation, Bolger said “a health care exchange is not something we wish to do, but we cannot stand idly by and hand over our citizens’ health care to an overreaching federal bureaucracy.”

Full Text of Speaker Jase Bolger Statement

Late Thursday, House Health Policy Committee Chair Gail Haines (R-Waterford) said House Republicans are still in no rush to act on health exchange legislation (SB 693) and that she supports Attorney General Bill Schuette’s call for the House to delay any action until after the November elections. ”We have taken a very prudent course up to this point, and I see us taking the same course now,” Haines said.

Wiener Associates will monitor all activity in Lansing very closely in the weeks ahead and provide immediate updates. Please stay tuned to this blog for future updates and breaking news.

Complete text of the Supreme Court’s opinion can be viewed below. Please allow sufficient time to download the document as it is large in size.