Health-care hearings are over: What happens next?

March 29, 2012

Now that the Supreme Court hearings are over, what will happen?

The justices must decide how they will rule on the case. They will consider the arguments they heard this week and others that were submitted in written form in addition to their own reading of the law.

When will they decide?

They can issue a ruling at any time, but a decision is likely to come in late June, just before they adjourn.

In the meantime, will anything happen to my insurance?

The health-care law will remain in force unless the court rules otherwise. Any changes that already may have been made to your plan to comply with the law are still in effect.

What changes may have been made to my plan because of the law?

If you have a private plan, it may, among other new features, now allow you to include adult children up to age 26. The plan also may cover preventive services such as colonoscopies and mammograms without charging co-pays or deductibles, and it will have eliminated lifetime limits on what it will pay for your care. If you are on Medicare, you also have preventive services with no out-of-pocket charges, and you are eligible for a discount on prescription drugs if you reach the program’s “doughnut hole” coverage gap.

When the court rules, what might it do?

The court could uphold the law, overturn it, strike some provisions while leaving others in place or rule that a decision must wait until the law takes full effect.

If the court overturns the entire law, what would happen to my 25-year-old daughter who is on my health plan?

Federal law would no longer require your insurer to cover her. But many states have incorporated this rule into their own laws, and it’s possible that it would remain valid at the state level even if the federal law is overturned. That appears to be the case in Virginia and the District of Columbia — although not Maryland — according to Katie Keith, a Georgetown University professor and author of a recent study of the issue. Also, your insurer could keep offering this coverage voluntarily. In fact, many chose to comply with this provision well before they had to.

I’m a senior on Medicare who has been receiving a discount on drugs. If the court overturns the entire law, would that go away?

Yes.

If the court overturns the entire law, w hat would happen to people with preexisting conditions?

The law has set up temporary “high-risk pools” to cover such people until 2014, when insurers will be barred from discriminating against them. Most of these pools are run by states. If the law were overturned, states could maintain the pools. But many might not, because they would no longer have access to federal funding the law provides.

What will happen if the court strikes down only the requirement that nearly all Americans obtain insurance?

All of the current rules discussed above would remain in force. And the provisions of the law that are set to take effect until 2014 would roll out as scheduled. Without the mandate, the law’s other requirements might substantially drive up insurance premiums. States could adopt their own rules requiring residents to get insured. Carolyn Quattrocki, executive director of Maryland Gov. Martin O’Malley’s office of health-care reform, said officials there would consider taking this route.

Staff writer Lena Sun contributed to this report.

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