WASHINGTON, June 24, 2012 — As politicians, campaign managers, and pundits anxiously await this week’s Supreme Court health care ruling, three years of bitter debate over the constitutionality of the Affordable Care Act (ACA, or Obamacare) will come to an end.
Once that’s decided, it is on to round two.
There are three possible outcomes of this week’s vote: The Supreme Court will either uphold Obamacare in its entirety, keep most of it but throw out the individual mandate requiring individuals to purchase coverage, or find the whole thing unconstitutional.
The political world will be watching the nine judges with bated breath to see which side will finally be vindicated.
In a sense, the real fun will be watching to see how each side can spin the landmark decision in their favour in the weeks ahead. If ACA falls, Obama will blame Republican opposition in the House and a “politicized” court, and will cast the GOP as the party that denied healthcare to millions of Americans. He will also use the Supreme Court as a campaign issue, pointing out the advanced age of some of the justices and the importance of not letting a Republican choose their successors.
If the individual mandate survives, the conservative base will be re-energized and Romney will begin outlining his plans for dismantling the law.
It will also make it easier to portray Obama as some kind of “socialist.”
It is unfortunate that both sides feel the need to continue along this path, seemingly unaware of just how broken the discourse surrounding American healthcare system really is. Something needs to happen if American healthcare can ever be reformed, and it needs reform now more than ever.
And that’s why in the end, the best scenario would be for Obamacare to stand in its entirety.
Under the Affordable Care Act of 2010, people with pre-existing conditions would no longer be denied coverage by insurance companies. This would make American healthcare coverage more humane and (at least somewhat) more equitable. There are also provisions specifically for young people. Following the passage of the legislation, people under 26 years of age can now be covered under their parent’s plan.
Both of these provisions ease the financial burden on individuals and families.
And if the whole law stands, business can breathe easy too. The expenses incurred by insurance companies for providing coverage to those with pre-existing conditions would be offset by the millions of other healthy (and therefore much less expensive) Americans added to insurance rolls.
In the second scenario, where the “individual mandate” is struck down but the rest of the law stays intact, insurance companies would be devastated. They would be required to sell insurance to anyone who wants it, even people with pre-existing conditions, which would encourage some people to wait until they needed coverage to buy insurance. Premiums would increase and those who remain uninsured would then find it even more difficult to purchase coverage.
And then there’s the third scenario: The “individual mandate” goes and all other parts of the legislation have to go with it. In this case, not only would healthcare coverage remain completely inaccessible to millions of Americans, but some people could actually lose the healthcare they’ve gained in the past couple of years.
Both parties recognize there are major problems within healthcare. But each party has gone about diagnosing those problems if very different ways. For Democrats, the tens of millions of Americans without health insurance coverage are the main issue. For Republicans, it is the spiraling costs of healthcare that need to be controlled.
Both are right to be concerned, but only one party has made any moves towards reform.
Romney’s pledge to immediately repeal Obamacare if elected would only add to America’s healthcare woes. And the fact that the President’s chances for re-election may rest on the Supreme Court’s decision only adds to the drama.
Obamacare is far from perfect. Besides the fact that the 2,700 page piece of legislation was passed without any Republican signatures, thus setting the stage for unprecedented partisanship, the law does very little to address America’s spiralling healthcare costs. These costs are a problem and play a large role in the current debt crisis facing all levels of government.
But the fact remains that America is the only major western industrialized state that fails to ensure all of its citizens have access to minimum levels of healthcare coverage. Given such strong Republican opposition to the legislation (and the individual mandate in particular), a Supreme Court decision against healthcare reform would be catastrophic and would set the reform process back at least another decade or two.
America desperately needs healthcare reform, and Obamacare is the answer.
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