This is a follow-up post to my earlier Affordable Care Act post, and is a discussion of how the ACA and the Supreme Court decision affects independent contractors, including Freelance Attorneys like those of us at the Montage Legal Group. In addition to my private practice, I have been a Freelance Attorney with Montage since November of 2011.
Yesterday, the Supreme Court upheld the Affordable Care Act (ACA) against two Constitutional challenges, and to the surprise of many, it was conservative Chief Justice Roberts who authored the opinion and provided the fifth vote, while centrist Justice Kennedy sided with the conservative dissenters. Although the legal issues in the case are fascinating, and I will discuss them, my main focus is on how the ACA and the Court’s decision will affect independent contractors, including freelance attorneys.
It is important to note that the Affordable Care Act, although it addressed access to affordable insurance, did not address many other pressing reasons that healthcare costs are spiraling out of control and unaffordable to many Americans. Former editors of the New England Journal of Medicine, Drs. Arnold Relman and Marcia Angell, have argued that changing compensation structures for doctors (from per-procedure to salary), clamping down on insurance companies and pharmaceutical companies, and creating more non-profits like the Mayo Clinic, among other things, would increase the standard of care and greatly decrease costs. Dr. Relman, incidentally, argued ACA’s individual mandate is unconstitutional as neither necessary nor proper in light of the available alternative of the widely popular single-payer system, which cuts insurance companies out of the picture. Dr. Atul Gawande also presented a convincing case study showing that when managed properly, lower expenditures could lead to higher-quality care. As a former medical devices engineer explained to me, “These [other] reforms are orthogonal to the healthcare act,” meaning that even with the ACA, other issues must be addressed to cut healthcare costs. And independent contractors bear these burdens more directly than employees who have costly group insurance that insulates them to a greater degree from spiraling medical costs.
In order to show how the ACA and Supreme Court decision affect independent contractors, I will discuss the scope of the decision, how the ACA and the Supreme Court’s ruling financially impact independent contractors, and finally, the legal mechanics of the decision.