Now that the Supremes have finished hearing arguments and begin to deliberate the fate of the Affordable Care Act it seems to be the time for predictions on how they’ll rule, so I’ll throw in my $0.02 worth.
I see a 5-4 decision to not only throw out the individual mandate but the entire law. The reason being that without the individual mandate the entire law collapses. Justice Scalia said as much when he remarked about the “cruel and unusual punishment” which would be forced upon the Court if they had to go through all 2,700 pages of the ACA and decide what stays and what goes.
Some of the so-called “experts” who have been following the proceedings have opined that the Supreme Court would be overstepping its bounds and ignoring precedent to make such a sweeping move. I would ask those who hold this belief if they were asleep when the Citizens United decision came down. That’s exactly what the Court did in that instance. They ignored 100 years of precedent in campaign finance law and expanded the scope of their decision well beyond the parameters of the original case in throwing out almost all limits and restrictions on contributions and doing away with transparency concerning those contributions.
So what will result from overturning the ACA? I would like to think it would be a starting point for Democrats to begin a push toward some kind of a single-payer system, but that would require backbone, something I haven’t seen much evidence of, so I doubt seriously it will happen. The more likely outcome will be that reforming our broken system will be viewed as politically toxic and one will want to touch it for the foreseeable future. Until the foreseeable future meaning the time when the entire for-profit health care system collapses, which it inevitably will.
We’ll go back to the pre-ACA system where premiums skyrocket and coverage decreases every year until health insurance will become one more thing that is limited to those privileged few who can afford it. Those who can’t are just SOL. Insurance will become so costly that employers will stop providing it, the premiums will be so expensive that employees who are dropped won’t be able to purchase it, and those with pre-existing conditions won’t be able to get coverage at any price. The only care available to most people will be by way of the ER, and those will be so swamped with patients and so burdened by the costs that they will be forced to close. That may sound like gloom and doom but I don’t see any other alternative.
With the demise of the ACA and its Medicaid requirement on the states, conservatives and their ‘drown government in a bathtub’ pied pipers will also use the Court decision as a jumping off point to not only do away with that program but Medicare, Social Security and any number of other government programs as well. They will argue the constitutionality of anything that contains any form of government mandate, and if those cases come before this Court I don’t have much doubt that the outcomes will be similar. Again, sorry to be so pessimistic but I don’t see much reason for optimism.
In closing, I have to make a comment on something James Carville said that just pisses me off, and makes for a sad commentary on the state of partisan politics in this country:
“I think that this will be the best thing that ever happened to the Democratic party because health care costs are going to escalate unbelievably,” said Carville. “Just as a professional Democrat, there’s nothing better to me than overturning this thing 5-4 and then the Republican party will own the health care system for the foreseeable future. And I really believe that. That is not spin.”
No, that’s not spin, it’s stupidity. And it’s not said as a “professional Democrat” but as a professional ignoramus. It may or may not be a good thing for the Democratic party, Mr. Carville, but will it be “the best thing that ever happened” to the millions who are going to join the ever-increasing ranks of the uninsured because of those escalating costs? What about for those young adults who can no longer be covered by their parents policies or the people for whom Medicaid is their only access to health care?
No matter who “owns the health care system” and who gets the blame sick people won’t be able to get treatment and some will die for lack of care. But who cares about that, it’s more important that political points are scored. That sounds like something John Boehner or Mitch McConnell would say.