Today the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act colloquially known as “Obamacare.” For the vast majority of our clients, the most important result of today’s ruling is the broad expansion of Medicaid, the joint federal-state insurance program for people with low incomes. The Affordable Care Act expands insurance coverage to an estimated 17 million people over the next 10 years. Specifically, the Affordable Care Act expands Medicaid coverage to people with less than 133% of the federal poverty level ($14,856 in 2012.) This will have the greatest impact on single adults without children, as those with children are typically already eligible for coverage under most states’ requirements.
While the decision found it unconstitutional for the federal government to punish states who declined to offer the expansion of Medicaid to its residents, it also acknowledge that as a practical matter, most states will likely accept the federal funds and offer coverage to its poor and uninsured. This is good news for our clients. Every day our office talks to seriously ill people without access to healthcare insurance. The problem seems to be particularly acute in Wisconsin, where drastic austerity measures have left hundreds of thousands of state residents would access to vital healthcare services. Two examples come immediately to mind:
- An epileptic women who has been turned away from her neurologists’ office because she could no longer pay hundreds of dollars out-of-pocket for the routine visits required for continued prescription of anti-seizure medications. Now, she has seizures requiring emergency room care and hospitalizations multiple times per month. The seizures may be causing permanent, long-term brain damage, but she does not qualify for insurance and is too sick to work.
- A woman with extraordinarily painful diabetic neuropathy in her feet, who is on the waitlist for coverage but who presently has to be carried around because she cannot put any weight on her feet. Her diabetes had been controlled with insulin before she lost her health insurance coverage.
Millions of other Americans are in similarly dire straights.
Under the Affordable Care Act, if states allow the federal government to fund expansion of Medicaid coverage, our clients will at least be able to see a doctor and receive treatment for their conditions while they’re waiting in line for a hearing before an Administrative Law Judge – great news, since according to recent congressional testimony, the average wait time is 340 days. The decision is also great news for the judges hearing Social Security cases, since their decisions are largely made based upon objective medical evidence. Once the Affordable Care Act is fully implemented, the courts will have better documentation of our clients’ physical and mental health impairments.
