President Obama’s second term officially begins this afternoon, but the signature legislation of his first term—the passage of ObamaCare—remains in substantial doubt. The political Left celebrated what seemed to be two clinching victories—the Supreme Court decision upholding the law in June, and then Obama’s subsequent re-election in November. But a series of three articles remind us why there are no such things as permanent victories in politics, nor any defeats that have to be accepted as irreversible.
*Politico’s David Nather has a thoughtful column exploring all the possible scenarios in which the implementation of the law might unfold. The best-case scenario is unlikely, because it means that young, uninsured people all have to go dutifully buy health care coverage. It’s their presence in the insurance pools that make it possible to insure people with pre-existing conditions. Insurance pools rely on large number of low-cost clients to cover the costs of those who require may care.
Unless young people can persuaded to buy health insurance, ObamaCare is doomed. And the incentives for them to do so are non-existent.
*George Will, writing in The Washington Post, points out how the very Supreme Court decision that was celebrated in the White House in June, has some nuances that will make solving the problem described above—young people staying out of the insurance pools—hard to solve. The Court said the law’s imposition of a mild fine if the mandate to purchase is ignored is low enough to be considered a tax—and therefore constitutional. Whereas, if the fine was significant, it would be considered financial punishment for failing to buy a product, and that would be unconstitutional.
This nuance in the decision means Congress—even if it was controlled by sympathetic liberals—would be hard-pressed to make the fine high enough to motivate young people to join the insurance pools. And to reiterate—without the young in the insurance market, the financial costs are not going to add up.
*Finally, even the Obama Administration has made a significant change in language, choosing to call the new health care exchanges, “markets”, rather than “exchanges.” This is a cosmetic change pertaining to the selling of the law to the states, who have to be cajoled into compliance, but the fact it’s the Administration that feels the need to change its PR tactics tells you something about how well—or in this case how poorly—their implementation efforts are going.
If all the proponents of ObamaCare wanted to do was reach out to people who were uninsured, and make sure people who had pre-existing conditions were covered, they could have expanded existing programs aimed at doing just that. In particular, a program to cover the latter would have been a legitimate case of the government picking up where the private market came up short.
But it wasn’t enough for the president and his supporters to do that. It was necessary, in their eyes, to use social engineering to try and control the lives of everyone, rather than just help those who need it. That was the real fight pertaining to ObamaCare, and while opponents might not get a silver-bullet victory, they can still ensure this law suffers death by a thousand cuts, if only one keeps their eye on the ball.
Dan Flaherty is the author of Fulcrum, an Irish Catholic novel set in postwar Boston with a traditional Democratic mayoral campaign at its heart, and he is the editor-in-chief of TheSportsNotebook.com