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Carrie Steckl, Ph.D.Carrie Steckl, Ph.D.
Finding Meaning Through the Many Windows of Wellness

Five Things to Know about the Affordable Care Act

Carrie Steckl, Ph.D. Updated: Jun 28th 2012

I find it interesting that the Supreme Court decision on the Affordable Care Act (ACA) was announced on what happens to be the hottest day of the year. Could our blazing outdoor conditions be an omen of fiery battles that will ensue now that the ACA has been upheld on almost all parts of the law?

judge's gavelIf you haven't been following this policy development, here are five things to know:

What happened today that's gotten everyone so riled up?

The Supreme Court upheld the ACA after it was challenged by Republican state officials and the National Federation of Independent Business.

Why the heck was the ACA challenged?

The Obama Administration put forth the ACA as a proposal to make healthcare more affordable to all Americans while also holding insurance companies accountable. A major component of the ACA is what's being called an "individual mandate" that will require nearly everyone to have healthcare coverage by the year 2014, or else pay a fine (interestingly, the Supreme Court is calling this a "tax penalty").

Republicans and the National Federation of Independent Business challenged the constitutionality of this mandate, saying that the government does not have the power to force Americans to purchase what is essentially a private product.

Does this mean that now I have to buy health insurance even if I can't afford it?

Not necessarily. According to the mandate, the following folks would not have to buy coverage:

  • Those who obtain an exemption for religious reasons
  • Incarcerated individuals
  • Undocumented immigrants (who would not be covered by the ACA)
  • Those who would need to pay more than 8% of their household income in order to obtain healthcare coverage
  • Individuals whose incomes are so low that they are not required to file a federal tax return, and
  • Members of Indian tribes.

The Urban Institute estimates that according to these parameters as well accounting for those who would qualify for federal subsidies to help cover the costs of insurance, approximately 7.3 million people - or about 2% of the population - will actually end up having to buy health insurance under the ACA's mandate.

What else should I know?

The ACA is more than the individual mandate. It also contains ten titles addressing issues such as healthcare efficiency, program transparency, and improving access to innovative medicine. To see the whole document, click here.

Title II (The Role of Public Programs) requires states to expand their Medicaid programs. However, the Supreme Court indicated that this violates states' rights and may be unconstitutional. This may be the one section of the ACA that the Obama Administration cannot claim as a victory.

What does this mean for mental health care?

We don't really know yet. It could potentially mean that more people will have health insurance to cover mental health care. However, it could also mean that those with mental health challenges - and those who are caring for them - may face new financial struggles when forced to purchase coverage with money they were previously using for mental health services and related types of care that are not usually covered by insurance.

That's why it's so important to take stock of your financial situation now - as well as that of anyone you are caring for - to ensure that you are in the strongest position possible to pay for the mental health care that is needed now and will be necessary later.

What are your thoughts on the ACA? Share them here, especially in relation to mental health care.


Carrie Steckl, Ph.D.

Itís a true blessing to have you visit my blog on mental health and wellness. I also write blogs on faith and caregiving in addition to teaching part-time for Columbia College of Missouri. For more information about my background and writing, visit my webpage at

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