First passed in March 2010 under a cloud of partisan bickering and populist anger, the Patient Protections and Affordable Care Act, popularly known as Obamacare, has faced a great many challenges to its legitimacy.
The foremost of these is undoubtedly the 26 state Attorney Generals currently suing the federal government on the legality of the so-called individual mandate, the mechanism within the legislation that allows the entire law to work. The efforts of these men and women finally culminated, after two years of battling in the legal system, in a case before the highest court in this country, the Supreme Court. The Supreme Court ended up hearing oral arguments during the last week of March and is set to make a ruling on it this summer.
It has to be said that the current batch of Supreme Court Justices is the most predictable in recent history. Almost everyone who knows anything about the nine justices knows four will usually vote left and four will usually vote right, while the lone independent on the bench, Anthony Kennedy, will generally be the deciding vote. It is for this reason that his questions and obvious skepticism concerning the legality of the individual mandate served as the center of attention during the process. The lawyers for the government found themselves trying to win a crucial vote in Justice Kennedy, a rather arduous task considering the man himself was once a brilliant lawyer.
The government’s case was built on the foundation that healthcare coverage is a necessary and essential utility for all members of the public; thus government must insure those who currently do not have insurance and force them to pay a fine in order to compensate for the cost of the government providing that service. Justice Kennedy did not seem to buy the idea that the government possesses the right, under the commerce clause, to force people to buy health insurance or make individuals pay a fine. This fact left many onlookers and pundits sure that the individual mandate will be struck down this summer, leaving President Obama with little to run on in terms of domestic achievements.
However, even if the case weren’t being heard in the Supreme Court, even if the individual mandate were somehow legal, that would not make the Affordable Care Act good for Americans. The week before the aforementioned Supreme Court proceedings commenced, the Congressional Budget Office (CBO) came out with new estimates that starkly differ from anything the Obama administration has preached over the past two years. Firstly, though the CBO estimates that the ACA will cost $48 billion less than it was originally thought it would from 2012-2021, the law will exponentially increase the federal deficit over time (starting in 2022 and 2023). This explicitly contradicts the foolhardy notion that Obamacare will decrease the deficit over time, as some Democrats like to brag.
In 2010, when the CBO came out with their first projections on the cost of the legislation, they included four years of no actual Obamacare spending; so, in reality, the 10 year projection only covered six years of spending. Also, they based their projections on a very strong economy with an unemployment rate of 4.9 percent by 2014.
The recent release, however, is not as rosy. Instead of having four years of non-spending, the projections cover two, 2013 and 2014, so they are a lot more accurate than the original projections. Also, the CBO has reviewed their economic projections and assumed that the economy will not be as strong as it was originally thought it would be, with the unemployment rate projected to be around 8.7 percent in 2014.
Additionally, according to the CBO, Obamacare will prevent some who currently have health insurance from keeping it—their best estimate being that around 5 million people will lose their employer-based coverage. The 2,700 page bill is riddled with loopholes and opportunities for both big corporations and small businesses to wiggle their way out of the obligation of providing their workers with health insurance, meaning a lot more people will rely on the new legislation than previously realized and the cost will be driven up even further.
Also, the cost of healthcare will, according to the CBO, go up instead of down—a fact that is perhaps more bruising to the current administration than any other. Health insurance premiums will skyrocket five and 10 years down the line, in most cases two or three times above the rate of inflation. This is because the bill failed to address the main reason that healthcare is currently so expensive. Thanks to the aging baby boomer population, the constant growth of frivolous healthcare lawsuits and the surprisingly steep surge in chronic diseases, not to mention new technology and other mitigating factors, the cost of healthcare will necessarily go up, even if Obamacare is enacted in the best way possible.
Methods such as tort reform, letting insurance companies compete across state lines, focusing on preventative practices such eating healthily and exercising, streamlining hospital records and affluence testing, among others, would go a long way to drive down the cost of healthcare, certainly further than Obamacare ever will.
Another reason that Obamacare is a miserable, doomed legislative initiative is the fact that it takes away half a trillion dollars from Medicare, a bedrock American safety net; and there is little way of knowing whether or not the federal government will be able to keep track of any of the funds.
Another big problem the current administration faces is the sheer unpopularity of the law. A CBS News/New York Times poll taken on March 21 showed that only 36 percent of the public approves of the bill, with 47 disapproving and only 17 percent not sure. If Obamacare is going to be front and center this fall during the general election, the president has little chance of winning, especially if the Supreme Court decides to strike down the individual mandate.
So here we are, knee deep in yet another presidential season, the news saturated with stories concerning the Republican presidential primaries and the insistence of Rick Santorum to keep on running. Come this summer and the conventions, and onwards to November, the incumbent will find himself trying to defend and deny things he currently holds dear to his heart. If the Supreme Court decides to uphold Obamacare, the backlash from the public will be so massive that Obama will be a lame-duck president for his entire second term (that is if he wins). If the court decides to rebuke it, he will have to endure criticism that he wasted his first year in office trying to pass a law that was illegal all along.
It is a lose-lose situation, but any student of contemporary politics knows never to count out the Teflon president—the absurdly smooth politician with a talent for slithering out of any controversy. It will be highly entertaining, not to mention remarkably important, to watch how this plays out. Here’s to hoping this law gets revoked and repealed in its entirety.