In a 193-page decision (downlad the PDF here), the Supreme Court of the United States issued its ruling on four issues related to the Patient Protection and Affordable Care Act  (P.L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) (together, PPACA).

Certain Congressional leaders have already made several statements about further action they have in the works.  However, whether any of the legislative efforts are ultimately successful is another story we are watching closely.

The following is a thumbnail sketch of the Supreme Court's opinion:

Issue #1:  Do states have the ability to challenge PPACA under the federal Anti-Injunction Act?

Ruling:  No.  The Court will make a current ruling on the validity of PPACA.

Issue #2:  Does the Commerce Clause of the Constitution of the United States give the federal government the right to mandate each individual to purchase health care insurance beginning in 2014 under PPACA or pay a fine?

Ruling:  No,  the Court held that the mandate violates the Commerce Clause, however, The Supreme Court holds that the individual mandate is constitutional under the general taxing authority of the federal government and upholds PPACA in its entirety.

Issue #3:  Should the entire PPACA be overturned due to the failure to include a "severability clause"?

Outcome:  PPACA stays in place and in force.

Issue #4:  Can the federal government expand Medicaid under PPACA (since it has a direct impact on states)?

Ruling: The federal power to terminate Medicaid funding to the states is narrowly read and will be limited.  The Court held that while the Medicaid expansion is constitutional it would be unconstitutional for the federal government to withhold Medicaid funds for non-compliance with the expansion provisions. In comments from the bench as reported by Bloomberg's SCOTUS blog, Justice Roberts noted, "Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding."

Your Nelson Mullins advisors are standing by to address any of your questions or concerns.  Please do not hesitate to reach out directly to any of the following individuals or any other member of your Nelson Mullins team:

Federal Strategies Team 
Bob Crowe
202.545.2908

Chris Cushing
202.545.2974

Ron Klink
202.712.2886

Mick Nardelli
202.712.2869

Jennifer Pharaoh
202.545.2975

National Healthcare Group
Barry Alexander
919.877.3802

David Main
202.545.2959

Helen Quick
202.712.2894

Executive Compensation and Employee Benefits Group
Sue Stoffer
404.322.6374