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ISSUE
ObamaCare: What you should know

Published:2013-Sep-23
Last Updated:2018-Nov-15
Principal Writer:Barry Shatzman

Issue Sections

Understanding The Issue
Court Cases
Issue Status
What You Can Do
More Information
The Rumor Mill

Reported News

Health Care Policy

Related Bills

Patient Protection and Affordable Care Act

2010 (HR-3590)

Related Court Cases

(2018) Texas v. United States
(2015) King v. Burwell
(2012) NFIB v. Sebelius

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States can refuse Medicaid Expansion

In 2012 the Supreme Court ruled in NFIB v. Sebelius that the mandate to purchase health care insurance is constitutional.

It also ruled, however, that the federal government could not compel states to expand their Medicaid coverage.

Subsidies are legal regardless of what exchange a state uses

In 2015, the Supreme Court heard oral arguments on a case claiming that wording of the Patient Protection and Affordable Care Act (Obamacare) specifically allowed premium subsidies only for policies purchased on state exchanges - and not on the federal HealthCare.gov exchange used by more than 30 states.

Had the court ruled in favor of the plaintiffs, millions in those states would have been left unable to afford insurance.

Had that happened, other remedies were possible...

o Congress could pass a law allowing the subsidies in states that would have lost them.

o States using the federal exchange could create their own exchange (though there are many obstacles to this and it is unlikely that could have happened in time to immediately help those affected).

However, the Supreme Court ruled that financially eligible Americans can receive subsidies regardless of whether their state maintains its own exchange or uses the federal one.

Republicans claim ObamaCare invalid without mandate

In the final days of 2017, President Trump signed the Tax Cuts and Jobs Act. Among the provisions of the bill - the penalty for not having insurance was reduced to $0.

A group of 20 Republican-led states then sued the federal government. They claimed that, without the mandate, the rest of ObamaCare (or at a minimum coverage for pre-existing conditions) is unconstitutional.


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