Right Change: What Happens to the Money if Obamacare Overturned?

With the Supreme Court’s decision on Obamacare looming on Thursday, Americans are curious to see which, if any, part of the law is upheld. Lost in the debate about what is best for the country or what is actually constitutional, is discussion on what happens to the billions of dollars already spent or pledged to carry out the law if parts or all of it are struck down. Many companies have already absorbed costs under the law and would be looking to recoup some or all of their expenditures

Supreme Court justices are not expected to provide any instructions for how to reimburse or redistribute this money. Those tasks will be left to federal government attorneys with little or no recourse for taxpayers. Pharmaceutical companies and primary-care physicians would be the most affected, given the extensive discount programs the law forced them to set up for Medicare patients.These groups have spent over $3.7 billion in discounts on prescriptions and care for seniors under the law’s provisions so far.
 


To date, Washington has handed out checks worth over $13.7 billion, according to research by the Kaiser Family Foundation. Around $4.2 billion, or about 31%, was sent directly to state and local governments. Most if not all of the money has already been spent or at least earmarked by these governments, making it impossible to recover.
Even if the Affordable Care Act survives the high court review, Congress could still attempt to repeal all or parts of the law, putting the billions already spent and billions more to come into jeopardy. “It’s definitely a concern,” says Matt Salo, director of the National Association of Medicaid Directors. “What the Congress giveth, the Congress can taketh away.”



House Minority Speaker Nancy Pelosi is on record as saying without the health care mandate, the law financially does not work. The massive expenditures written into the law require the income from millions of new insurance company clients in order to stay solvent. So it remains to be seen if the law can stand even if parts of it are upheld. Thursday promises to be a landmark day, but it may be just the beginning of the huge health care debate that lies ahead.

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