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Birmingham Bar Association Bulletin Winter 2015

Health Care Reform LaVeeda Morgan Battle, Battle Law Firm, LLC, and Co-Chair, BBA Medical Liaison Committee US Supreme Court Declares Health Care Reform The Law of the Land Since the historic Patient Protection and Aff ordable Care Act (“the Act”)(sometimes called Obamacare) passed in 2010, it has been embroiled in controversy and partisan combat challenging its legality. With a bi-partisan coalition of justices, the United States Supreme Court decision in King, et al. v. Burwell fi nally ended the debate with a pronouncement that the essential four pillars of health insurance reform in the Act are now the law of the land. Th e Ki ng decisi on fi nall y freed t he Act fr om f urt her fr ontal attacks on its fundamental legality. Th is article will explain the key components of the Act that aff ect individuals, employers, and the health insurance industry and summarize the Supreme Court’s reasoning in the King decision. HISTORY OF HEALTH CARE INSURANCE The Federal Government’s Initial Response Th e history of the health insurance industry in the United States that led to the adoption of the Act was signifi cant in the Court’s decision in King. Th e Court noted that the Act grew out of a long and sordid history of failed health insurance reforms in the United States. A patchwork of insurance coverage was stitched together by the federal government to allay rising health care costs, provide broader insurance coverage, and regulate the health care industry. In 1951 the Internal Revenue Service declared group premiums paid by employers a tax-deductible business expense to encourage employers to provide health insurance for their employees. Subsequently, Medicare was established in 1965 to address the gap in health insurance for the uninsured elderly. Th at same year, Medicaid was adopted providing federalized health insurance coverage for pregnant women and children living in poverty. For many years, all other attempts to allay rising health care costs, provide broader insurance coverage and regulate the health care industry failed. Insurance companies sought to limit their liability by covering only individuals without “Medicare was established in 1965 to address the gap in health insurance for the uninsured elderly.” pre-existing serious health conditions. Th is limit on insured individuals spawned the Emergency Treatment and Labor Act of 1986 that required hospital emergency rooms to treat individuals regardless of their ability to pay. Th is patchwork system created ever escalating health care costs for employers and the insured, and debilitating personal debt for uninsured individuals. State Efforts to Reform Health Insurance Massachusetts has long been a leader in insurance reform. Relying on a Massachusetts law passed in 1927, state after state stitched 12 Birmingham Bar Association


Birmingham Bar Association Bulletin Winter 2015
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