In California, the U.S. Supreme Court’s surprise ruling upholding the federal health care reform law means that perhaps four million people currently without health insurance will be able to obtain coverage after the law fully kicks in during 2014.
The operations of the state’s Health Benefit Exchange, the first in the nation created to implement federal health care reform, will go forward as a central marketplace for coverage, in which people can shop online for policies at competitive prices.
A number of other pieces of health care reform in California remain undisturbed, including the change allowing adult children living at home to remain on their family policy until the age of 26.
Chief Justice John Roberts, a conservative, was joined by liberal Justices Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor in the majority for the 5-4 ruling. Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.
Even if the requirement that people obtain coverage or face a tax penalty had been struck down, other pieces – perhaps 95 percent of the law -- would have gone forward in California.
Those include the “the Exchange subsidies, the efforts to control costs, the consumer protections, etc. It still would be the most historic and far-reaching legislation since Medicare and Medicaid in the 1960s,” Health Access Executive Director Anthony Wright wrote prior to the decision.
James T. Hay, the president of the 35,000-member California Medical Association, said the Supreme Court's decision on the Affordable Care Act was a mixed bag.
"Expanding coverage to more Californians, putting an end to insurance industry abuses, and support for primary care are essential for our patients and the future of medicine,” he said. “Despite these wins, the ACA builds reform on the broken foundations of Medicare and Medicaid without addressing the underlying problems and inadequate funding. CMA will continue to work to fix those ills.”