The University of Missouri’s legal panel has taken a look at the Affordable Care Act and its impact on Missourians and the November election.

University of Missouri Law Professor Joshua Hawley says the government mandates directed towards individuals to purchase the insurance have made the Affordable Care Act controversial. “There’s not another instance that anybody can think of, which the federal government has directed this to be done before expanding Medicaid and directing the states to undergo or to undertake an expansion to Medicaid using some federal funds but not enough federal funds to cover the full expansion was also quite controversial,” he says. “And then of course there are the procedural aspects, about the way that the law was written and then passed. It was passed using a reconciliation procedure. Largely unprecedented, mostly unprecedented use of that reconciliation procedure in order to avoid a filibuster that was also quite controversial.”

Hawley says the prospects for repeal are very low, if the Democrats win the Presidential election. However he says there is a likelihood of significant change to the law or repeal if the Republicans win.

So what could that mean for Missouri families? Hawley says the biggest concern of families with low to moderate incomes who are unable to afford insurance is that they still won’t be able to afford insurance even after federal subsidies become available. He says the federal government will set up an insurance exchange if the state does not do so. “However, the (state) law does not permit the federal subsidies for individuals to be available in the event that the federal government sets up an exchange. “If that in fact is the case and how the law is applied, then I think it will be very difficult to expand insurance coverage because the cost of insurance will be quite high, and I think it will be found that without a subsidy, it will be very difficult for anybody, but especially those of low income,” Hawley says.