It’s finally June. That means—if the Supreme Court delivers on its promise—that we’ll soon know the fate of the Patient Protection and Affordable Care Act.
Though, analysts at Moody’s Investor Services point out, “we will likely have as many questions as answers” after the ruling. After all, what really happens after the ruling comes out will also be dependent on the outcome of the November elections.
Uphold the law as is
There’s good and bad things here.
As least according to Moody’s Investors Service, if the PPACA is upheld, it could have negative credit implications for health insurers even though their coverage base will increase.
Kill the individual mandate and keep the rest
Though critics of the PPACA have said the entire law must fall if the individual mandate falls—since the law contains no severability provision calling for the rest of the act to remain intact if one part is tossed out—this potential outcome is one we keep hearing time and time again.
By far, the individual mandate has been the most heavily debated provision of the entire law. Even proponents of the law have said they thought requiring people to buy health insurance was unconstitutional. A Kaiser Family Foundation poll finds seven in ten Americans oppose this provision, including 53 percent of the public who say they hold “very unfavorable” views of it. Overall, half of Americans (51 percent) believe the court should rule the mandate unconstitutional.
Throw it all out
Again, there’s good and bad news with this ruling.
If the entire health care law is thrown out, this would be seen as a credit positive for health insurers, according the Moody’s report. If the PPACA stands, health insurers will face the regulations and restrictions mapped out in the law, including the medical loss ratio and aggressive reviews of rate increases. Additionally, Moody's analysts say employers may eliminate their health insurance programs in favor of the health insurance exchanges and individual mandate, thus putting more pressure on health insurers.
There are other options—the Court could kill the part of the law that requires insurance companies to cover people regardless of medical problems, throw out the expansion of the Medicaid program or decide that a ruling is too premature—which is probably the biggest wild card of all.
But no matter what the ruling is, as mentioned, the presidential election in November can change everything again. And despite what does happen with the future of the PPACA, health care has, and will be, changed.