Affordable Care Act

​While the federal health-care law has reduced the number of uninsured people by about 10 million, challenges remain, including how to educate new enrollees about their coverage options. New research at Washington University shows that communicating information about the Affordable Care Act can be made simple.

The new federal health-care law gives millions of Americans access to medical insurance. However, choosing the right coverage — a daunting task for most people — could be even more difficult for those who have never had health insurance, according to a new study at the School of Medicine.​​

The controversy and legal battles surrounding the contraception mandate in the Affordable Care Act have led to a new – and worrisome – legal concept: the idea of a “corporate conscience,” warns Elizabeth Sepper, who teaches at Washington University School of Law in St. Louis.

Corporations’ religious freedom claims against the Affordable Care Act’s contraception coverage mandate miss a “basic fact of health economics: health insurance, like wages, is compensation that belongs to the employee,” says Elizabeth Sepper, JD, health law expert and associate professor of law at Washington University in St. Louis. Sepper’s scholarship explores the interaction of morality, professional ethics, and law in medicine.

The survival of the Affordable Care Act in the Supreme Court presents a monumental moment to improve the U.S. health care system, says Elizabeth Sepper, JD, health law expert and associate professor of law at Washington University in St. Louis. “It is a uniquely American crisis that 50 million Americans don’t have health insurance and another 29 million are underinsured, meaning getting sick would ruin them financially even though they’ve been paying for insurance,” she says.

“I expected the Court to uphold the Affordable Care Act (ACA), however, two elements of this decision are very surprising: the fact that the mandate survives under the taxing power while failing under the Commerce Clause and Necessary and Proper Clause, and the fact that Chief Justice Roberts was in the majority without Justice Kennedy,” says Gregory Magarian, JD, constitutional law expert and professor of law at Washington University in St. Louis. “Roberts’ vote looks to me, as a first impression, like a brilliant piece of judicial strategizing.” Magarian is a former U.S. Supreme Court clerk 
for Justice John Paul Stevens.

The Supreme Court’s decision today means the implementation of the Affordable Care Act can go forward, thus improving the delivery and affordability of medical care, says Timothy McBride, PhD, health economist and associate dean for public health at the Brown School at Washington University in St. Louis.

“Chief Justice Roberts’ opinion on the Affordable Care Act mostly conforms with the way I previously understood the taxing power of the federal government,” says Adam Rosenzweig, JD, tax law expert and associate professor of law at Washington University in St. Louis. Rosenzweig says that there were two important pieces of the Roberts opinion from a tax standpoint.

Gregory P. Magarian, JD, professor of law, and Timothy D. McBride, PhD, professor of public health, both at Washington University in St. Louis, are available for expert commentary on the Supreme Court’s Affordable Care Act decision.

A new study suggests that health insurance exchanges, a key provision of the Affordable Care Act passed in 2010, may need to be monitored by policymakers to make sure there is sufficient competition between private insurance plans. In the study, published in Health Affairs, Timothy McBride, PhD, professor and associate dean for public health at the Brown School at Washington University in St. Louis, examined the insurance premiums, availability of plans and enrollment levels under the Federal Employees Health Benefits Program (FEHBP). “From its inception, the health reform legislation used the structure of the FEHBP to guide the design of these exchanges,” McBride says.