Q&A: Health care ruling's impact on Minnesota

This morning, the U.S. Supreme Court upheld the 2010 health care law, including the new requirement that everyone have health insurance. Though the court took issue with the law's expansion of Medicaid, it declined to block it as long as the federal government doesn't withhold existing Medicaid funds if states decide not to expand the program to cover more people.

Q: What happens to the uninsured in Minnesota?

A: The ruling is a relief for the 9 percent of Minnesotans who are uninsured. That's low compared to other states, but the uninsured still make up nearly a half million people here who will now have expanded access to coverage.

Q: During the health care debate, President Barack Obama highlighted the Mayo Clinic as providing exemplary care. Does the law change how Mayo does business at all?

A: No. In fact, the Obama Administration cited Mayo to demonstrate how many of the reforms in the health care law could function in reality. For instance, Mayo will continue coordinating care so that the different doctors treating a single patient communicate and work together to help that patient stay healthy. Mayo was doing that long before the health care law was adopted.

Supreme Court Ruling
• Continuing coverage: Big Story Blog
• Read the ruling: Transcript
• Obama's reaction: Transcript
• Romney's reaction: Transcript
• Minnesota reaction: Politicians, union members comment
• Q&A: Ruling's impact on Minnesota
• Agree with the court? Take our poll

Q: Minnetonka-based UnitedHealth Group is one of the largest health insurance companies in the country, but it doesn't have a huge portion of customers in Minnesota. How will the health care law affect UnitedHealth Group and other insurers who have many Minnesota policyholders?

A: The health care law means many more customers for health insurance companies.

On the other hand, the court did say that the federal government can't threaten to withhold money from states that don't participate in the Medicaid expansion, which provides coverage for the poor. So that means some insurers could see fewer new enrollees.

Whether states decided to expand Medicaid or now will be particularly important to UnitedHealth Group because it has a subsidiary serving Medicaid patients in 23 states. Meanwhile, HealthPartners, Blue Cross, and Medica for example, have been preparing for an influx of new customers.

Q: How will the court's opinion on the Medicaid expansion affect Minnesota?

A: It appears states now have a choice on whether to participate, and won't be penalized if they don't. But the Dayton Administration has made clear that it will go through with the expansion. As a result, Minnesota is expected to receive an estimated $826 million to help provide health care for people it previously funded with state dollars through the former GAMC program and Minnesota Care program. After 2013, the state is expected to receive more than $2 billion in federal money between January 2014 and July 2015.

Q: Minnesota is home to a large medical device industry. There is substantial debate over a new device tax in the health care law that's meant to help pay for the Affordable Care Act. What happens to this tax now?

A: The tax is upheld because most of the health care law was upheld. However, there's been a bipartisan attempt in Congress to repeal the tax. What happens next on that effort remains to be seen.

Q: Is this the last hurdle for the health care overhaul?

A: Not in the least. Republicans have threatened to repeal it. If the GOP wins majorities in the U.S. House and Senate this election year and takes the White House, they'll have a shot at it.

In Minnesota, the GOP controlled Legislature has refused to authorize online health insurance marketplaces, a cornerstone of the law.