The Supreme Court opinion brings certainty to everyone impacted by the PPACA, including insurance companies, states and government programs. It is now clearly the law of the land and everyone must comply with it. It does not, however, end the litigation about the PPACA or bring closure to the Medicaid debate. The opinion also breathes new life into the argument about the limits of the commerce clause.
A number of cases remain pending in lower courts about specific provisions or programs created by the PPACA. Because the mandatory insurance provision was upheld, the court did not need to address whether other parts of the PPACA were valid. As a result, those cases will continue in their normal course and be adjudicated individually. For example, the PPACA prohibits doctors from owning hospitals. The Physician Hospitals of America has challenged that provision. If the court had struck the PPACA in its entirety, it would have struck that provision as well. Now that case will continue on its own merits.
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