What Now for Obamacare?
Yesterday, the Supreme Court finished hearing oral arguments over the constitutionality of the Patient Protection and Affordable Care Act of 2010.
Obamacare is the single-most politically divisive piece of legislation of our era. Its the first sitting president’s signature piece of legislation that the Supreme Court is to seriously consider declaring unconstitutional since the days of Franklin D. Roosevelt’s New Deal – 75 years ago.
This much we know for sure… the future of health care in this nation hangs in the balance.
What’s the Beef?
More than half the states in the United States, 26 states, brought a combined lawsuit challenging the constitutionality of Obamacare.
The constitutional controversy is primarily over enactment of the individual mandate that requires all Americans to buy health care insurance under the Commerce Clause of the U.S. Constitution:
To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes
– United States Constitution; Powers of Congress; Article 1, Section 8, Clause 2
The 26 states think that is pretty shaky ground and steps unconstitutionally on their state’s authority. The Constitution clearly says:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
– United States Constitution, Amendment 10, Power of States and People
This oversimplified explanation is the gist of the case.
A Political Continental Divide
Few major pieces of legislation in the history of the United States has been more polarizing and blatantly partisan than Obamacare.
It isn’t that anyone believes we don’t need health care reform or that it isn’t a good idea to provide health care to all Americans. The only bipartisan agreement there is, is that we need both!!
Its the way Obamacare came about and how it is written that transformed healthy two-party debate into a political cancer that is eating away at the heart of the nation today.
The Democratic Mandate of 2008
President Obama and Democrats interpreted their sweeping wins in 2008 as a mandate to do just about anything they darn well pleased… without any Republican input at all.
The national mood back then was hatred of George W. Bush. Republicans were blamed for everything, but especially for the Great Recession of 2008. The electorate was mad as hornets!
The Making of Obamacare
Obamacare was crafted entirely within the Democratic Caucus. Republicans were excluded 100% from the process. Not a single scrap of Republican input from the many detailed bills they proposed were even considered. Not one single word!!
That included such good ideas as selling insurance across state lines and tort reform to reduce medical malpractice costs. They would have made “The Affordable Care Act” more affordable. Now, already, the CBO reports Obamacare’s costs will be almost twice as much as advertised. It will go up more as Obamacare’s main features come online.
In the end there was so much underhanded wheeling and dealing in smoke-filled backrooms they had to re-panel them to remove the stench.
From that process we got such things as “The Cornhusker Kickback” and “The Louisiana Purchase“; not to mention politically redefining the Medicaid state reimbursement FMAP amounts to favor states with shaky support for Obamacare.
The Final Obamacare Vote
In the Senate:
- Not a single Republican voted for Obamacare
- Not a single Democrat voted against Obamacare
In the House:
- Not a single Republican voted for Obamacare
- All but 38 Democrats voted for Obamacare
Most of the 38 Democrats that voted against Obamacare were allowed to do so by then Speaker of the House Nancy Pelosi because they faced tight reelection campaigns in 2010 in states where Obamacare was unpopular.
It didn’t help… Republicans won back the House in a huge landslide in 2010.
What Will Happen to Obamacare?
There have been all kinds of complex constitutional arguments thrown back and forth over the last several days on both sides of the fence.
Here is a simple, pragmatic prediction:
If the current political polarization in the U.S. extends to the Supreme Court then parts of Obamacare will be declared unconstitutional in a 5-4 decision
There are 5 conservative leaning justices and 4 liberal leaning ones. Given how Obamacare passed in the Congress, it is a logical guess that voting will go the same with the court.
Yeah… I know what you are thinking… the Supreme Court is above all that and will decide through legal precedent and constitutional law. It will.
Unfortunately, though, it looks like there isn’t a legal precedent that covers this situation and a new one must be decided. That sets up for a non-partisan, but philosophical party line vote.
Democrats deserve all the credit or all the blame for Obamacare. It is their baby… lock, stock and barrel.
Where it goes from here, though, is anyone’s guess.
The worst possible disaster would be that the individual mandate is struck down but expansion of Medicaid to 30+ million more low income Americans is allowed to stand. In that case, taxpayers would be stuck for the balance.
Then, a government already teetering on the brink of insolvency, with a $15.6 trillion dollar national debt that’s growing by a whopping $4.3 billion/day will quickly go ballistic unless drastic changes for increased funding are not immediately made.
In any case, Obamacare would then become an unprecedented failure.
The legacy of a President and of Supreme Court justices will soon be etched into the history books for all time because of this one decision.