The U.S. Supreme Court has upheld in its entirety the Affordable Care Act, the health care reform law that is the signature domestic achievement of the Obama Administration.

The court ruled 5-4 with Chief Justice John Roberts joining the liberal wing. Roberts in the opinion noted that the individual mandate--the core provision of reform that would pay for many of its initiatives--“is not a valid exercise of the Commerce Clause,” which covers congressional ability to regulate commerce. However, the court added that Congress has the authority to implement the mandate under the taxing clauses of the Constitution.

The ruling leaves intact new health care programs in various stages of implementation, including substantial expansion of community care centers in medically underserved regions, accountable care organizations with coordinated population health management programs, coverage for persons with pre-existing medical conditions, coverage on parental policies for adult children up to age 26, and lower prescription drug costs for many persons, particularly those on Medicare.

Information technology initiatives authorized in the law include statewide health insurance exchanges, “operating rules” to make HIPAA electronic claims and related transactions more standardized, new HIPAA transactions for electronic fund transfers and claims attachments, expansion of data analytics fueled with the availability  of Medicare claims data, a health plan identifier, electronic enrollment in health and human services programs, and a new tax on medical devices including those collecting and/or transmitting data.

The Court, while upholding the law, did place restrictions on the expansion of Medicaid. It ruled the federal government cannot withhold traditional Medicaid funding to states if they restrict elements of expansion or take their time expanding.

The opinion soon will be available at supremecourt.gov, Click on Opinions and then Latest Slip Opinions.

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