Wrapping Up Historic Supreme Court Health Reform Debate

History was truly in the making last week as the Supreme Court heard arguments both for and against the Affordable Care Act (ACA).

Among other changes, the ACA enacted a provision that’s important for supportive housing when it was signed into law in 2010: It expanded Medicaid eligibility to people living at up to 133% of the federal poverty level.

As the court began hearing arguments on the constitutionality of this and other elements of the ACA (notably the insurance mandate), thousands of citizens flooded the sidewalks and streets surrounding the Supreme Court to voice their support of the ACA. And CSH was among them.

Securing resources for services is often the most difficult piece of the supportive housing puzzle. When residents are not eligible for insurance and enrolled in Medicaid, providers are left to piece together fragmented primary and behavioral health care resources. That means more challenges for supportive housing staff and residents--especially in states without dedicated supportive housing resources.

But health insurance and especially Medicaid can play a significant role in helping supportive housing programs find sustainable services funding. The ACA not only assures that residents are covered, but it also contains several Medicaid benefit options for states—offering flexibility to adopt the tactics that work best.

So far, the primary argument against the ACA when it comes to this Medicaid expansion is that the states would be forced to accept federal funding in order to support their Medicaid program under the new provisions. To this interpretation, Supreme Court Justice Ginsburg responded: “Isn’t that true of every Medicaid increase? That each… and every time, the condition is ‘if you want the Medicaid program, this is the program. Take it or leave it.’”

At CSH, we hope that the rest of the Supreme Court follows her lead. We will follow developments in the case and will report updates as they become available.

And we hope you will follow the case as well. The National Council for Community Behavioral Healthcare has a detailed summary of the issues at stake and of the three day hearing, as does FamiliesUSA.


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