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The Supreme Court has spoken and President Obama's 2010 health care law — including its controversial individual mandate — will stand.

In a 5-4 vote, the high court ruled that the law — known formally as the Patient Protection and Affordable Care Act, or PPACA — is “a valid exercise of Congress’s power to tax,” reports MSNBC.com's Tom Curry.

“It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but (who) choose to go without health insurance,” Chief Justice John Roberts wrote in his majority opinion. “Such legislation is within Congress’s power to tax.”

Curry further explains:

“The law, Roberts wrote, 'makes going without insurance just another thing the government taxes, like buying gasoline or earning income. And if the mandate is, in effect, just a tax hike on certain taxpayers who do not have health insurance, it may be within Congress’s constitutional power to tax.' “

The debate over the decision will be spirited, to say the least, and we'll include as much of the relevant analysis here as we can, including the following:

In the meantime, the Business Learning Institute's Karl Ahlrichs has some thoughts on what will happen next.

Ahlrichs is a senior consultant at Gregory and Appel (the oldest independently owned insurance agency in Indiana) and a national speaker and thought leader in wellness and workplace safety. He breaks down his analysis into two camps:

Key political points:

  • Republican House leaders say they will quickly force a vote to repeal the law. House Democrats are carrying “pocket cards” (talking points) detailing how the reform law has already helped people (e.g., 86 million have received free preventive care).
  • The administration will have to continue to provide much needed -– and overdue -– guidance for states, employers and insurance companies, among others, to answer the many outstanding questions that are holding up implementation of the law.
  • There will be a chorus of voices advising everyone to wait until after the fall elections before taking further action.
  • There will be more court cases challenging other provisions of the PPACA.

Key insurance issues:

  • Full-scale implementation of PPACA will continue unabated.
  • The Medicaid program will largely remain as envisioned in the PPACA. States will continue to push for flexibility on the MOE; in response, the administration will grant 1115 waivers, but with reform elements.
  • Democrats will continue to introduce Medicare savings through payment adjustments and minimal benefit changes.
  • Delivery reform will continue at the current pace, with some provisions being shelved due to budgetary constraints and HHS capacity.
  • Many of the hesitant states will move to build exchanges while some will continue to refuse to comply. Many state exchanges will not be operational until 2015.
  • All insurance reform provisions will remain in effect.
  • The premium subsidy will move forward uninhibited.

Stay tuned …

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