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PPACA Supreme Court Review – Day Two

The Second Day of Supreme Court review of the Patient Protection and Affordable Care Act (PPACA) lived up to the promise of being controversial. Each side laid out their case as to why they believe or don’t believe the individual mandate is constitutional.

As expected, it is shaping up to be where Justices Roberts and Kennedy land on the issue. If both side against, the mandate will likely be struck. But if they split on the issue, the mandate will likely be upheld.

Justices seem focused on two issues. First is the limiting principle. In this case, is the mandate constitutional under the commerce clause because it is limited in nature? Can the government articulate such a limit? The government is arguing that it is not compelling the purchase of insurance and therefore it is a limited activity. However, the government is penalizing non-participants – those who don’t buy insurance. This is where the second issue comes in. Can the government regulate inactivity — in this case being uninsured?

Kennedy, Roberts and two other conservatives all asked questions that would lead one to think they are dubious on the question of constitutionality. Kennedy and Roberts probed both sides rather deeply, but seemed more critical of the government’s case on the mandate. On the issue of regulating inactivity, Kennedy seemed concerned that that could go too far. However, the government justifies this by saying the individual is impacting overall economic well-being by doing so. Kennedy seemed open to this argument.

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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