California laws that implement or build upon the federal health reform law might need to be reconsidered if the U.S. Supreme Court strikes down the federal overhaul, according to state lawmakers, the San Bernardino County Sun reports.
The San Bernardino County Sun article was produced by the California HealthCare Foundation's Center for Health Reporting. The Center is supported by a grant from CHCF, which publishes California Healthline (Bazar, San Bernardino County Sun, 6/18).
Background on Health Reform Efforts in Calif.
Since President Obama signed the reform law two years ago, California lawmakers have passed several state laws related to the overhaul, including measures that:
- Allow young adults to remain on their parents' health insurance plans until age 26;
- Block insurers from setting lifetime caps on health benefits;
- Establish a state health insurance exchange; and
- Prohibit insurers from denying health coverage to children with pre-existing conditions.
The state Legislature is debating additional measures related to the federal reform law, including a proposal that would prohibit insurers from denying health coverage to individuals of any age with pre-existing conditions.
Background on Supreme Court Case
The Supreme Court case centers on whether the federal government can require residents to purchase insurance and whether federal lawmakers have the power to pressure states to expand insurance coverage through Medicaid.
The court is expected to make a decision by the end of June.
The Kaiser Family Foundation has estimated that California could receive an additional $45 billion to $55 billion in federal funds between 2014 and 2019 if the health reform law is upheld (California Healthline, 4/2).
Implications of Supreme Court Decision
Sen. Ed Hernandez (D-West Covina) said that the fate of state laws related to the federal overhaul are under a "cloud of uncertainty" until the Supreme Court rules on the constitutionality of the law. He said, "We will have to rethink everything" if the reform law is partially or entirely overturned.
Hernandez said, "We have to reassess all of these measures. Some of them are actually contingent upon the implementation" of the federal overhaul. He said that if the state laws become invalid, California lawmakers "have to start all over and turn those [laws] into statutes that are not dependent on the federal government."
However, Geoffrey Joyce -- director of health policy at the Schaeffer Center for Health Policy and Economics at the University of Southern California -- said implementing such statutes would require funding. He said, "They cost money. There's no doubt about it when you mandate things like expanding coverage to kids or banning lifetime maximums."
Considering State-Based Reform Measures
Hernandez said he is considering introducing a statewide individual mandate if the Supreme Court strikes down the federal mandate. He noted that he might consider other state-based reform measures as well.
However, experts say that a statewide individual mandate and the state insurance exchange cannot be successful without federal funding.
Kim Belshé -- former secretary of the state Health and Human Services Agency and current board member of the California Health Benefit Exchange -- said, "If those federal funds disappeared or were enjoined by the [Supreme Court], California would be back to the drawing board" (San Bernardino County Sun, 6/18).