Home > General Info, In the News, Policy > Supreme Court Issues Ruling on Affordable Care Act

Supreme Court Issues Ruling on Affordable Care Act

The U.S. Supreme Court issued its ruling today on the constitutionality of the Affordable Care Act.  The Justices ruled that the individual mandate — the requirement that most Americans buy health insurance – is constitutional.  Without a doubt there is much to consume in the several hundred page decision, including the decision on whether states can be forced to expand Medicaid.  What seems clear however is that the individual mandate will be allowable as a tax on citizens.

Vaccination coverage was explicitly addressed in the statute; requiring all health insurers to provide all ACIP recommended vaccinations with no co-payments or other cost sharing requirements (deductibles) when the vaccines are provided by an in-network provider.  Health advocates have been preparing for the full implementation of these provisions, including an anticipated reduction in the number of plans “grandfathered” out of the requirements until they make “significant changes” to their plans. Today’s decision directly impacts the manner in which Americans of all ages will attain and pay for vaccinations into the future.

The President’s 2013 budget request to Congress for funding to the CDC for immunization programs nationwide, known as the Section 317 Immunization Program, was based on the assumption that the Affordable Care Act would remain intact.  On June 14th, the Senate Appropriations Committee approved the FY 2013 Senate Labor-HHS Appropriations bill at $157.7 billion, approximately $1.4 billion above the FY 2012 bill. The Centers for Disease Control and Prevention (CDC), the agency through which the Section 317 Immunization Program is funded, has an overall funding level of $6.9 billion.  This level is a $55 million increase over the FY 2012 level and a $277 million increase over the President’s Budget Request.  Compared to FY 2012, the Senate bill provides level funding for the Section 317 Immunization Program at $620 million, an increase of $58 million (10%) over the President’s Budget Request.

Immunization advocates, including the 317 Coalition seek an appropriation of $720 million.  With the Supreme Court ruling on the constitutionality of the Affordable Care Act, members of the House and Senate must now come to the table to sort out how this nation will finance vaccination programs throughout the nation.  Stay tuned…

  1. Lawrence
    June 28, 2012 at 10:59 am

    Wow – I am surprised, who would imagine that Chief Justice Roberts – supposedly the Conservative Ringer on the Court would provide the swing vote. There are going to be some pretty angry Tea Partiers out there…..


  2. lilady
    June 28, 2012 at 5:45 pm

    I gave the chance of passage at less than even odds…I’m delighted.

    I barely skimmed through Roberts’ majority opinion and haven’t read Scalia’s minority opinion. One political pundit, states that Scalia’s opinion *reads* as though it was the majority opinion. If so…it would mean that Kennedy had already declared himself and Scalia assumed that Roberts would the tiebreaker, declaring the plan unconstitutional.

    IMO, the plan was is a watered down version of real health care insurance reform…but it is a start.


  3. Sharon
    June 29, 2012 at 2:59 pm

    I absolutely agree, lilady. We still need to be paying attention, looking at this as a beginning…not an end. CNN reported Roberts as saying something to the effect that the Court should support elected leaders on this issue and that it is not the Court’s job to protect the people from the consequences of their choices. I took that to mean their election choices. Very interesting decision.


  4. Firebat620
    June 29, 2012 at 4:43 pm

    Informative and succinct post. Thanks.
    I’d like to hear more about this:
    “Today’s decision directly impacts the manner in which Americans of all ages will attain and pay for vaccinations into the future.”


  5. lilady
    June 30, 2012 at 2:32 pm

    @ Firebat620: The VFC (Vaccines for Children) Program is set up to provide *free vaccine* to VFC providers for children who are “underinsured”:


    “Underinsured: A child who has commercial (private) health insurance but the coverage does not include vaccines, a child whose insurance covers only selected vaccines (VFC-eligible for non-covered vaccines only), or a child whose insurance caps vaccine coverage at a certain amount. Once that coverage amount is reached, the child is categorized as underinsured. Underinsured children are eligible to receive VFC vaccine only through a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC).”

    However, VFC providers who administered these vaccines to children who are underinsured, are permitted to charge for administering the “free vaccines”

    “If your child meets one of the VFC eligibility criteria listed above, the vaccine must always be provided free of charge.

    Free of charge means just that. The vaccines have already been paid for with federal tax dollars. This means that no one can charge a fee for the vaccine itself.

    However, each state immunization provider has been granted (by law) the ability to charge what is called an “administrative fee.” An administrative fee is similar to a patient’s co-pay, in that it helps providers offset their costs of doing business.

    The amount of the administrative fee differs from state to state, based on a regional scale determined by the Centers for Medicare and Medicaid Services (CMS). Consult this chart for the maximum regional charges for vaccine administration by state Adobe Acrobat print-friendly PDF file [PDF-121KB, 2 pages]”

    Parents who have private medical insurance will no longer have to worry about deductibles, co-pays or yearly caps. Nor, will they have to seek out a VFC provider, who bills them for administering “free” VFC vaccines. Every private medical insurance plan is now required to cover every Recommended Childhood Vaccine and to cover completely the costs associated with administering the vaccines.


  6. July 4, 2012 at 1:10 am

    Hello my friend! I want to say that this post
    is amazing, great written and come with approximately all vital infos.
    I’d like to peer extra posts like this .


  7. lilady
    July 4, 2012 at 9:37 am

    @ Pop Over….I smell Spam.


  8. Quokka
    July 4, 2012 at 9:46 pm

    As an Australian who has access to significant health care safety nets I have followed this situation closely. In fact I was holding my breath as the news was announced – congratulations all. I agree health care is the long game but I know this will mean greater access to health care for more people and that is a great thing.


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