On a hot, historic day in Washington, the Supreme Court voted to uphold the main tenet of the Affordable Care Act, ruling that the individual mandate was constitutional. The Justices came down on the issue 5-4, with Chief Justice John Roberts voting with the more liberal Justices to uphold the law.

The court’s ruling on Medicaid expansion, the other main issue in the law, is less clear. A majority of the Court held that it would be unconstitutional for the federal government to withhold Medicaid funds from states that choose not to comply with expansion, but it remains to be seen what the legal implications of this decision will actually be. 

We will continue to provide you with regular updates as we learn more about how today’s ruling on the Affordable Care Act impacts the paralysis community. 

UPDATE 2:20 pm

As a national, nonprofit organization dedicated to improving the quality of life the approximately 6 million people living with spinal cord injury and paralysis, the Reeve Foundation strongly supports many important provisions of the Affordable Care Act (ACA) that bring the country one step closer to ensuring that all Americans, including people living with spinal cord injury and paralysis, have access to high quality, comprehensive, affordable health care that meets their individual needs and enables them to be healthy, functional, and live as independently as possible.

Today’s decision by the United States Supreme Court to uphold the constitutionality of the health reform law ensures that people living with spinal cord injury and paralysis will continue to benefit from provisions of the ACA, including:

Key Insurance Reforms

Pre-Existing Conditions -- Effective September 2010, health insurers are prohibited from discriminating against children under the age of 19 who are living with disabilities (and other pre-existing conditions). In January of 2014, the law will take effect for all Americans. This means that people living with a pre-existing condition will no longer be denied coverage, charged higher premiums, or have their coverage rescinded following an injury.

Lifetime and Annual Benefits Caps -- One of Christopher Reeve's greatest fears was that he would exceed the lifetime cap on his insurance coverage. Most families don't realize that their coverage includes a cap and when that limit is reached their coverage ends. No population is more affected by these caps than those suffering from catastrophic injury or illness. Under the ACA, lifetime caps on benefits are prohibited. After 2014, both lifetime, as well as annual caps, will be prohibited completely.

Improving Coverage

Essential Benefits -- Under the new health care law, most health insurance plans (including new plans to be offered in the state health insurance exchanges) are required to cover at least the following essential benefits: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services (including behavioral health treatment), prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services including oral and vision care. For people living with spinal cord injury and paralysis, the inclusion of rehabilitation and habilitation services is a welcome improvement.

Many people with disabilities depend on these services; but prior to health care reform, many insurance plans did not cover them or limited the number of treatments covered under the policy.

Home and Community-Based Services -- The health reform law includes several provisions to expand home and community based services offered through state Medicaid programs. These provisions will make it easier for people living with spinal cord injury and paralysis to live at home and continue to participate in their communities, rather than being forced to receive needed services in an institutional setting.

The Reeve Foundation strongly believes that no one should be forced to choose between living at home and receiving the services they need.

Related Links:

Supreme Court Ruling on Health Reform Upholds Key Benefits

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Americans react to historic health care decision

Woman living with SCI waits for Supreme Court’s health care ruling

Read the Supreme Court ruling