Your guide to health reform

The Supreme Court will weigh in on health care reform this month. (AP Photo/J. Scott Applewhite, File) The Supreme Court will weigh in on health care reform this month. (AP Photo/J. Scott Applewhite, File)

With the Supreme Court decision due any day on the fate of President Obama’s Patient Protection and Affordable Care Act, it’s a good time to look back on what’s happened. Here’s your guide to everything health reform related.


It’s been quite the two years since President Obama signed the PPACA into law on March 23, 2010—with tons of provisions being implemented. From the young adult provision to coverage of preventive care services, read what's been implemented year-by-year.

Despite all the debate the law is getting, the fact is Americans don’t understand it. Even young adults say they are mostly indifferent on the outcome of the Supreme Court ruling.

Just after turning two, the PPACA hit the big time. It was introduced to the Supreme Court. The case ran from March 26-28—meet the lawyers in the case here, and listen back on what was said in the case.

What will happen

Though there’s a number of ways this can go, there’s three most likely outcomes. Here's some information on what options will mean.

Invalidate the whole law. But some say undoing health reform could have messy ripple effect. Many states are well into implementing health reform. Hawaii just declared its intent to develop a state-based insurance exchange. And some of the largest insurers in the business have come out to say they’ll still abide by some of the aspects of PPACA regardless of what the Court does.

Kill the mandate, keep the rest. The major player of the PPACA has been the individual mandate. All sorts of polls confirm the mandate is the law’s least popular element. Even Howard Dean, a proponent of universal health care, told attendees at the Benefits Selling Expo that the mandate wasn’t necessary. Employers also seem convinced it will be killed.

Uphold it. A timeline details the many provisions in the law. A recent report estimates the rebates insurers will pay this year due to the law’s medical loss ratio requirement.

Kill the mandate and other insurance reforms. Fewer people would be covered, but it would help insurance companies. It would mean popular provisions such as requiring insurers to offer coverage to all regardless of medical status (guaranteed issue), and prevent charging more to people with pre-existing conditions (community rating), would be eliminated.

Rejects the law’s expansion of Medicaid to low-income adults. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at or below 133 percent of the federal poverty level as of January 2014. But this isn't exactly a probable outcome, as many are convinced the justices upheld this.

Other factors

As Dean said, the big problem with the reform law is that there is no cost control. There’s been conflicting reports on just what it will cost us. One report from a Medicare trustee said reform could tack on $500 billion to deficit. Read what the cost impact health reform can have.



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