BUFFALO, N.Y. -- The long-awaited Supreme Court ruling on President Obama's signature health care law upholds much of the act's intentions to expand coverage, with one major exception, says to a University at Buffalo Law School professor who is an expert on health care.
"That exception has to do with the expansion of the Medicaid program," says Anthony H. Szczygiel, founder and director of the William and Mary Foster Elder Law Clinic at UB's Law School. "The president's health care act encouraged states to expand Medicaid, but the president's plan also went further and gave the secretary of Health and Human Services the authority to withhold all Medicaid funding -- not just that related to the expansion -- if states fail to expand the Medicaid programs."
Szczygiel says the bottom line is that the Supreme Court ruling will accomplish much of what the act intended, in terms of expanding health insurance.
"But the expansion of Medicaid coverage will be a matter of state choice," he says. "And thus in some states, the added coverage will be more limited.
"Everything stays in effect, but the intention of the act to expand coverage is somewhat tempered by the ruling of the court because of Medicaid expansion."
Szczygiel said the Affordable Care Act fundamentally changes the Medicaid program, making it much more like private insurance.
"The Court held that each state needed to be able to say 'yes' or 'no' to that fundamental change," he says, "without the coercion posed by the threat of losing all federal funding for their current Medicaid programs."
Szczygiel also said the majority decision was "very respectful of the government's separation of powers." Congress sets the policy, whether that be good or bad.
"If the people don't like it, they can vote against the policy makers," he says. "The Court only decides whether Congress acted within the authority of the Constitution, and the Court should give Congress the benefit of the doubt when considering that question."