A ‘Back of the Napkin-esque’ Review of the SCOTUS ACA Decision Tree

By Gregg A. Masters, MPH

While trolling for interesting tidbits on the web, I came across what appears to be a simplified representation of the impact of the Court’s ruling. The original piece was offered by Emily Corwin and posted under the title ‘SCOTUS And The Affordable Care Act: An Overview.’

A deeper dive into the ‘WIFM’ department i.e., what’s at stake, Corwin frames the following source quotes:


If struck down, Medicaid itself could be deemed unconstitutional. This would create radical changes, since “medicaid is the workhourse of the nation’s health system, covering 30 percent of all children, 70 percent of nursing home residents and 40 percent of all deliveries,” reports Phil Galewitz.

If upheld, many more people would become eligible for Medicaid. The federal government would assume much of the additional costs initially, slowly transferring 10 percent of that burden to states by 2019.


If struck down, “49 million Medicare beneficiaries could lose a variety of benefits that have already kicked in,” writes Marilyn Werber Serafini. These include prescription savings, preventative services, and wellness visits. However, if only the individual mandate is struck down, “nearly all of the health law’s Medicare changes will remain intact.”


Even excluding maternity coverage, the National Women’s Law Center found that nearly one-third of the most commonly sold insurance plans charged women aged 25 to 40 at least 30 percent more than men for the same coverage,” writes Julie Appleby. The ACA would bar insurers from charging women higher premiums than men. Other provisions include requirements regarding maternity coverage, and removing copays for mammograms and contraceptives.

With additional source reference to ‘What’s at Stake for Patients‘ and A Consumer’s Guide to the Health Care Reform Law‘ as credible third party issue framing and explanation.

Thank you @EmilyCorwin!


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