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On the Third Hand: Litmus tests

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I’m human, and hurried. I make too many typos and too many errors, and I’m not any kind of Patient Protection and Affordable Care Act (PPACA) expert. I’m just someone who tries to write articles about PPACA.

But I’ve come up with three indicators that show whether people writing about the topic are even even more lost than I am. 

1. They write as if the PPACA exchange system is the same thing as PPACA.

No, it’s not. Whether it’s good, bad or mixed, it’s just one part of the PPACA commercial health insurance provisions, and that’s just one part of PPACA.

2. They say the U.S. Supreme Court “upheld PPACA” in June 2012, or could “kill PPACA” when it rules on King vs. Burwell.

No. In June 2012, the Supreme Court simply knocked down one set of constitutional objections to the PPACA individual coverage mandate. Another plaintiff could still get the mandate thrown out using some other legal strategy.

If the court rules against the Obama administration in the King case, it would simply end the ability of the PPACA exchanges run by the U.S. Department of Health and Human Services to provide premium subsidies.

That might give the PPACA exchange system a hard blow, and it might destabilize the state-based exchanges, by causing sicker people to flood into the states with state-based exchanges that could still offer premium subsidies.

See also: 10 states where the Supreme Court may help short-term health sales.

But, at the same time, maybe states that currently hate the exchange program would have second thoughts and find a way to save the programs. Or some other thing would happen that would keep the HHS exchanges on track. It’s hard to know till we know.

3. They refer to the Patient Protection and Affordable Care Act (PPACA) contraceptive services mandate.

Kathleen Sebelius, the secretary of the U.S. Department of Health and Human Services, created the mandate when she approved a preventive services packages proposal developed by an advisory group. PPACA simply requires the HHS secretary to develop a basic package of preventive services that all PPACA-compliant major medical plans have to cover without cost-sharing. It says nothing about whether the package has to include coverage for contraceptives.