More on ACA

So last night’s “Left, Right and Center” represented a reversion to form.  David Frum was in the “Right” chair, and Matt Miller was back, representing the “radical center.”  Miller referred listeners to this D.C. Appeals Court decision, which now allows me to understand anything that came up in day 1 of oral argument of the Florida case in the Supreme Court:

http://thinkprogress.org/wp-content/uploads/2011/11/DC-aca-opinion.pdf

Frum, who supports the individual mandate and thinks it is constitutional, was, I believe, president of the local Federalist Society where he went to law school, and I think he went to Yale (no – he went to Yale but he attended law school at Harvard).   Frum and Miller were holding out hope that the oral argument was misleading and that the mandate, and the law in its entirety, will be upheld.

I am surprised that the example of auto insurance has never come up in the discussions of ACA I have heard.  You have the same insurance problem of adverse selection, free-riders, and so on.  The only difference between the auto insurance market and the health insurance market is that it is somewhat less necessary to drive than it is to have a body — but not that different in many parts of the US.

Robert Scheer was trying to maintain that there are no negative externalities from a refusal or financial inability to carry health insurance, but that is clearly wrong.  Has he never heard of communicable diseases?  And it certainly seems to me that the government at any level, local, state, federal, would be well within its rights to compel people of all ages to have vaccinations, and I have no doubt whatever that the government at all levels would exert this right if it were obviously necessary to the public health.   I don’t think the negative externalities from a population not receiving adequate health care has received nearly the attention it deserves in this legal context.   I have no patience whatever with the kooks who think that vaccinations are causing autism.  The burden of proof is on them, and I am confident that they have not, and cannot meet it.

I now think the penalty for not abiding by the mandate in ACA was not called a tax because it is not a tax, it’s a penalty.  As Steph said, had it been called a tax, then the tax probably would have been challenged.  The Commerce Clause challenge based upon activity/inactivity seems the more serious one, but if the challenge is upheld I really do think it will be time to think about a nonviolent revolution that looks to a new constitutional order — either a new, more prescriptive constitution, or no constitution.  Alternatively, we can wait for 75 or 100 years for different appointees, but that’s a luxury we and the world may not be able to afford under current demographic, ecological, and technological conditions.

I am of the opinion that the “new conservatism” is mostly backlash due to affirmative action legislation and jurisprudence.  It wasn’t civil rights legislation per se that made the Right go crazy, it was affirmative action, of which school busing is a kind of subset.

 

 

 

40 thoughts on “More on ACA

  1. Steph

    Auto insurance doesn’t come up for two reasons. The first is that you have to drive to be subject to the requirement, so that’s a decision to avail yourself of the market, and thus gets around the bogus (IMO) activity/inactivity argument. The second, and more important, one is that all the auto insurance laws are state laws, not national ones. The interstate commerce clause argument is important because we are arguing about what Congress has a power to do, not some limit on governmental powers generally. That’s a point worth making, although I’m sure everyone here understands, because libertarians intentionally distort the argument and try to claim that there’s some limit on governmental powers that makes it wrong for the government to compel you to do something, no matter what that something is. There’s no good faith argument for that in the Constitution.

    Now, as for why the action/inaction thing is bogus. In every other case in which interstate commerce has been tested, the issue is whether the regulation as a whole affects interstate commerce. When we talk about specific pieces of the legislation (the individual mandate), the question is whether they are necessary to the overall legislation (the Necessary and Proper Clause justifies these). Scalia himself made this point in Gonzales v. Raich, the case about private growers of marijuana. Until after the ACA passed, no one, other than libertarian types who have all kinds of off the wall arguments, thought that you could attack a law on the basis that now seems may work.

    Beyond this, the fact that we have created laws such that people get emergency care no matter what, even if they themselves do not consent (because they are unconscious, perhaps), means that everyone is in the health care market. There is no group of people that is not. Scalia et al. seem to want to distinguish between the health care market and the health insurance market and thus make it impossible for us to require that people pay for health insurance (seemingly because he thinks that we should deny care to those unable to pay, which is just shocking and awful). But within the system we have, that distinction makes no sense. Specifically, health care is so expensive that the average person cannot pay for care in the case of significant injury/illness (which we do cover through the emergency basis), unlike burial expenses.

    For what it’s worth, I ended up in a long argument yesterday with co-workers who are anti ACA (and totally right wing), who acknowledged that some kind of tax and credit scheme would be fine and thus that what they were upset about was the policy, not any Constitutional issue. The best I could get out of them as a Constitutional argument was (1) they wanted to cut back the interstate commerce authority (which has been a conservative desire, for lawyers, anyway, since the ’30s, and definitely since the civil rights cases like Heart of Atlanta), and is a promise by the conservative justices in the ’90s that was basically abandoned by Gonzales v. Raich; and (2) it is terrible that someone could have a personal objection to buying health insurance and yet also be in non compliance with the law, even if the only result was the payment of a penalty, because some people just are uncomfortable with being in non compliance with the law, even if there is no risk as a result. The latter makes no sense to me, so I think it might be a liberal/conservative mindset difference, even though I’m reasonably conservative in a lot of ways. The analysis of the law from business types has always been that lots might choose to pay the penalty rather than provide/buy the insurance, because that would be cheaper.

    Reply
    1. Ocean

      That was great, Stephanie. This past week, at work, someone was asking me what I knew about this issue (as if I knew). I was able to explain in very general terms, but your post is very informative and now I have a better understanding of the issues (although I don’t know what those legal precedents are).

      Reply
      1. Steph

        Two key precedents are Wickard v. Filburn (1942) and Gonzales v. Raich (2005), the latter being relevant because of how recent it is, how it was seen as stopping a possible trend to cut back the expansiveness of the Commerce Clause interpretations, and because Scalia concurred.

        Wickard dealt with a part of the New Deal that limited the amount of wheat farmers could grow. The challenge was that the plaintiff’s wheat was grown only for his families’ use and not for commerce and thus was not placed in the market at all, let alone in interstate commerce. The Court held that that didn’t matter, since the overall scheme of limits affected interstate commerce and even growing wheat for home use has an economic effect, as it effects demand. Similarly, in Gonzales, the plaintiff sought to take advantage of a state medical marijuana statute to grow marijuana for home use and challenged the use of federal drug laws to the extent they applied to this non-market activity. Again, based on the overall scheme, the applicability of the act even to personal, non market activity was upheld.

        Creatively, the plaintiffs here are arguing that the mandate is different, since those not buying insurance aren’t doing an activity, whereas people growing wheat or marijuana are. The problem with this is that there’s no basis in the Constitution or the precedents for this distinction. The question is whether there’s an impact on the market that the law goes to, and clearly people not having health insurance has such an impact, especially since in most cases people will end up needing health care that others have to foot the bill for.

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        1. Ocean

          Your explanation makes me wonder whether the impact on the market and having others footing the bill, includes government programs like Medicare or SS disability. If someone requires medical care, doesn’t have insurance, and therefore doesn’t receive it, the medical condition may result in disability. In that case SSD and Medicare may have to pick up the tab. Another situation would be people who don’t pursue routine care during their younger years, when they don’t have insurance, and as a consequence their health is poorer by the time they get to their older years, retirement and Medicare benefits. One could argue that neglected conditions are going to be more expensive to treat later. Related to this, I wonder if there are statistics that show cost of healthcare through Medicare during, say the first five to ten years after age 65, for people with and without previous health insurance.

          Thank you again.

          Reply
      1. Ocean

        If you leave it to Ron Paul that would certainly be the case. That’s exactly what he was advocating in that famous (infamous?) interview when he insisted that the young man that suffered an accident shouldn’t expect medical care. He was clearly referring to EMTALA. He can’t even plead ignorance on that since he is a physician.

        So, yes, the agenda expands. Very regressive indeed.

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        1. Wonderment

          Yes, that’s a problem. I don’t think they can actually relitigate EMTALA, but the “commerce clause” healthcare precedent from the court will further empower the right wing to expand the attack on “big government,” especially mandates, especially-especially unfunded mandates.

          If Romney wins in 2012 there’s a good chance that the Court will go entirely hard-core radical right wing. The stakes are high.

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    2. ledocs Post author

      “The interstate commerce clause argument is important because we are arguing about what Congress has a power to do, not some limit on governmental powers generally.”

      Yes, but we are also talking about how insurance markets work, and what might be reasonable for government to mandate of the individual, regardless of current law and the US constitution.

      Suppose half the states require that all drivers not only have valid licenses but that they carry bodily injury liability insurance, and half the states require only a valid state licence. Then suppose that there are lots of accidents across state lines involving uninsured drivers. Or suppose further that a large subset of the cross-state accidents occur on federal highways. Isn’t this completely unworkable? And doesn’t there have to be federal legislation to guarantee that all commercial truck drivers, whether in- or out-of-state, carry liability insurance? I don’t know what the current state of play is. And I don’t know how it came to be that every state except New Hampshire requires that all licensed drivers have bodily insurance liability insurance, how long that took, and so on.

      Suppose two drivers with only minimal bodily insurance limits (say, $30,000, as in California) or no insurance at all have an accident in which at least one of them ends up a paraplegic. What happens? There have to be a number of such accidents in the US every year.

      When people are standing around the water cooler discussing this stuff, it’s generally a matter of abstract political theory, not of the history of constitutional interpretation, about which even most lawyers know very little, I imagine. So my point was that, even given this very crucial legal distinction between state law and federal law and the Commerce Clause in the constitution, my sense would be that nearly everyone can see the logic in requiring that all drivers carry liability insurance. How that happens doesn’t matter much to the abstract discussion of insurance and the general welfare.

      But, of course, the minimum bodily liability limit for auto insurance is too low, because states recognize that most adults need to drive to survive and that many cannot easily afford high insurance premiums. I am surprised to learn just now that California appears to have one of the lower minimum requirements, lower than Texas and Mississippi, anyway.

      Auto Insurance Map of US

      And there was this complaint that some of the Supremes don’t seem to have a firm understanding of how insurance markets work.

      Most people don’t “need” high bodily injury limits because they have few assets. But what happens when two poor people are in an auto accident and at least one of them ends up requiring life-long care? For that matter, what happens when it’s just a one-driver accident? If the person is a citizen, he ends up on federal disability, I suppose. What will that cover?

      “According to the National Spinal cord Injury Association, 44 percent of all spinal cord injuries are caused by car accidents. Additionally, approximately 12,000 new cases of spinal cord injury are reported each year in the United States.” This is not from a government source, but from a personal injury attorney.

      Source Link

      Reply
      1. Steph

        I don’t at all disagree with your argument about why the feds could regulate auto insurance, including with an individual mandate. Of course, I think the health care mandate is Constitutional. I’m just saying that that’s not going to convince the people who are currently anti-mandate. (For the same reason, Romney can distinguish the MA law and the ACA, although it’s also perfectly clear that Romney suggested that a federal law with an individual mandate was the way to go, like many others on the right, until the Dems adopted it.)

        There’s actually a conflict within the rightwing opposition. One part is relying on the technical (or made up) distinction between this case and cases like Wickard, despite the absence of any “original intent” support (or other support) for that distinction. These people admit that this is a purely technical, procedural argument and that the gov’t could have easily done the same thing or gone farther through some other means. My assumption, based on the bad faith that has been demonstrated so far, is that whatever means was used would have been fought as hard, but at least these people are acknowledging the argument isn’t about government overreach or expansion in any real way, but means.

        The bigger part of the rightwing opposition, however, claims that the law is actually beyond what the gov’t can do, and that would be the case no matter how it was achieved. These people are generally bothered by the MA law, at least to some extent, also. There’s an interesting mix within this group. The loudest ones are Tea Party and other rightwing populist types who simply don’t understand the legal arguments and are buying into the Socialism! type arguments. But the intellectual backbone of the legal challenge are libertarian scholars who want radical change in our law along the lines of the Substantive Due Process arguments. These people WOULD say that it’s somehow a violation of civil rights to require someone to buy insurance, just as it was a violation of rights to have child labor laws or minimum wage or maximum hours laws, even if they won’t fully defend the older arguments from the turn of the last century.

        It’s important to notice this, because the current Justices would in theory be quite suspicious of these libertarian arguments, but might accept the current framing for what seems to me a clearly results-oriented partisan motive.

        Reply
  2. Wonderment

    The conversation should also include the politics of the fiasco and why, if struck down, the law is such a huge blow to Obama and Dems.

    I continue to be shocked that the Obama admin. bet the ranch on this long, incomprehensible, ill-conceived and now — as we see — impossible-to-pass-muster Mother of all Healthcare Laws. (“We’ll know what’s in it after we pass it.”)

    I don’t buy for an instant that smart Dem. lawyers, — and they are legion in the WH and Congress — didn’t know we would end up exactly where we are today: rolling the dice on Justice Kennedy.

    The alternative course of action was keep the law very simple. Model coverage on Social Sec. and Medicare (tax-funded) or, even simpler, expand Medicare downward (gradually) in age eligibility. (This idea was actually floated in desperation by liberals at the end, but McCain-supporter Libermann killed it, as a Democrat!)

    The response from Dems is that nothing like what I outline could pass. But it doesn’t follow from the lack of political power (although the Dems. owned Congress and Obama’s approval rating was off-the-charts) that Obamacare was a viable option.

    Even if by some disorder of temporary blindness (caused by life in a bubble of hubris) the lawyers and professional advisers didn’t foresee the challenges, the law still basically sucks, and the states, who were left to somehow pay their share of it, were right to go ballistic. (Dem-governed states didn’t go ballistic out of loyalty to Obama.) Progressives across the board said the law was inadequate for a variety of reasons (locked out immigrants, no public option, sell out to Big Insurance, etc.) but accepted it on a “it’s-better-than-nothing” (barely) basis.

    When polling consistently showed that voters disliked Obamacare, the Dems. explained it as “Oh, they just think they hate it because they’re too dumb to understand it; once benefits kick in, everyone will love it.” (Another example of utter Dem. cluelessness.)

    So now, if overturned, the state of healthcare goes from the current clusterfuck to Uber Clusterfuck due to unravelment. If the Justices toss “merely” the mandate, the law is rendered utterly unworkable and farcical. The only possible win for Obama (and even that’s not a win because people will still hate the law) is that SCOTUS says, “Just kidding; it’s all good.” Not likely.

    If I can make these arguments for how great a fiasco the law has been, believe me Republicans — even Romney who was an early supporter of the mandate — can do it with 100 times greater damage.

    Democrats now claim that defeat of Obamacare will energize the base like never before. I have my doubts. It will energize Obama fans like never before, but that’s not the base. The base got bullied and intimidated into supporting a bill we never liked.

    Reply
    1. claymisher

      Wonderment, if you think destroying the insurance industry would have been easier than passing ACA (and making it stick) then you’re just completely insane.

      Reply
      1. Wonderment

        I don’t recall making any suggestions about destroying the insurance industry. That is your creative phrasing, just as calling me crazy is. (Didn’t you also toss me a random insult in the @nader thread?)

        Anyway, the insurance industry doesn’t have to be left to die of malnutrition. On the other hand, it doesn’t have to be given massive amounts of government “food stamps, either” as it is under Obamacare. Obama caved into insurers in the same fashion that Bush caved into Pharma in passing Medicare Part D.

        My first inkling of just how bad Obamacare really was occurred when I discussed with my Farmers agent (a good friend) just how delighted middle and upper echelon management was with ACA. Given their traditional hostility to any healthcare proposed by Dems., this came across as cognitively dissonant to my friend.

        In retrospect, I think the insurers completely outsmarted the pols. They knew they had a win-win situation: Obamacare care passes and they have vast new captive markets; Obamacare fails and they are back to glorious business as usual.

        Reply
    2. graz

      “When polling consistently showed that voters disliked Obamacare, the Dems. explained it as “Oh, they just think they hate it because they’re too dumb to understand it; once benefits kick in, everyone will love it.” (Another example of utter Dem. cluelessness.)”

      Do you have a cite for that claim? Or is that just the jilted “base” in you venting?

      “Democrats now claim that defeat of Obamacare will energize the base like never before. I have my doubts. It will energize Obama fans like never before, but that’s not the base. The base got bullied and intimidated into supporting a bill we never liked.”

      Just as you are being bullied into supporting and voting for this loser (Obama) again!
      Is your never ending bitching the consolation for betraying your conscience, again and again? Go green!

      Reply
      1. Steph

        People apparently still don’t know what’s in it, which is a problem, but I think a broader political problem. Remember, people whose taxes went down think their taxes went up in many cases.

        Reply
    3. Steph

      Well, I’ve explained before, here and at Bob Wright’s blog, why I disagree strongly, and I think your comment here misstates the facts. But why repeat myself.

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    4. miceelf

      Sure the law sucks. It’s also a dramatic improvement over the status quo.
      Perhaps you’re making “these arguments for how great a fiasco the law has been” elsewhere, but here you’re just saying it sucks and would suck even if single payer wasn’t possible. “basically sucks” isn’t really an argument.

      I don’t honestly know where your insistence on the existence of a senate where the dems are all Sharrod Browns and there aren’t any Liebermans or Nelsons in the group comes from, but it tends to detract from one’s view that you are realistic about what is possible legislatively. Sure, “dems owned congress.” Just like my uncle Fred owned the cabin that he locked a rabid bear in. It was true on paper and you could make a convincing argument on it, but that had no bearing on what could actually be done with said ownership.

      Reply
      1. Wonderment

        There’s going to be endless Monday morning quarterbacking and weaving of alternate histories over the ACA, so I will preface my comment by conceding that we’re only speculating. I’m inclined to speculate, however, about the leadership in the WH. Would LBJ have been able to twist arms in the Senate where Obama couldn’t and wouldn’t? Did experience matter? Was there internal dissension about priorities among aides and advisors? Was there a clear enough message to the electorate from the WH on health care? Could Obama have drawn a line in the sand on public option, if not single payer? Did we really need a gargantuan bill? Was Obama too laid back, letting “the process” run its course? Was this an unnecessary sellout to the insurance industry? Should lawsuits by 28 states and the current state-of-affairs at SCOTUS been anticipated?

        There’s plenty of blame, of course, to go around, and I’m the first to say that the most contemptible characters among Dems. are Nelson and Lieberman, followed by “pro-life” Dems, followed by anti-immigrant Dems. Furthermore, it’s true that Republicans have blocked healthcare reform and benefits for decades, except when it meant huge kickbacks to special interests (Medicare D under Bush). It’s also true that Republicans have appointed radicals to the SC for decades, including young justices (longevity matters) like worst-of-the-worst Clarence Thomas.

        Still, it didn’t have to turn out THIS bad, and even if ACA is upheld by SCOTUS it will be years before we’ll be able to assess whether it’s “a dramatic improvement” or just a shuffle of a stacked deck, or to stick with a medical metaphor, a band-aid for a gaping wound.

        Reply
        1. Ocean

          IMO, your first couple of paragraphs of assigning blame are an exercise in futility. We could go on and on considering whether the current congress is the same as LBJ, or whether Republicans then were different from Resp now, and on and on and on. It is what it is. This is what we have. What are we going to do about it? Obama is who we have. The Republican Party is what it is now.

          As to the medical metaphor, the current ACA as we know it, is a bandage, no question. Insurance companies, pharmaceutical companies and other health related for profit companies continue to bleed health dollars into stockholders’ pockets. Health reform, true universal healthcare, and public option are the only hope to solve some of the more serious problems we are facing with financing healthcare.

          Reply
          1. Steph

            Right. I know it’s idealistic, but if ACA gets struck down, I think that actually moves the country toward single payer sooner. It shows the problems of some of the incremental approaches.

            I think this idea that we could have elected an “LBJ” who would have made everything better is really based on an extremely unrealistic idea about both the health care problem and politics today, but so be it. It seems important for some that Obama be the scapegoat. Maybe it feels better to have someone to blame and that another person would have fixed it. Perhaps that’s easier than seeing the problem as more systematic.

            What seems to me to demonstrate the unreality of this blame the president thing is the claim by Wonderment elsewhere that Hillary Clinton would have avoided the problem. Clinton was pushing for the individual mandate and it just seems impossible to me that the plan wouldn’t have been basically as long and complex. Indeed, if one wants this kind of incremental approach (which she did) and if one wants to control costs (which she did, and which needs to happen), then the idea that she wouldn’t have ended up with a really similar bill seems inconceivable.

            But I suppose people can believe anything they want. The right claims that Hillary would have been more moderate than radical socialist Kenyan Obama (they’d claim the opposite if she had been elected); some in the far left claims now that Hillary would have been more effective, more able to push through bills, and more left wing (unbelievably). This all seems ridiculous and a terrible waste of energy.

            Reply
            1. Wonderment

              It may be a waste of energy, and I began my post by conceding that Monday morning quarterbacking was highly speculative, but I don’t think trying to figure out what went terribly wrong with the Obama administration (and occasionally right) is ridiculous. The conventional wisdom, which you seem to subscribe to, is that there are just a set of intransigent forces (in his own party, among the opposition and among interest groups, media) that stymied Obama at every turn. Any criticism of him is viewed as “scapegoating.” You can make a case for that, but demeaning other explanations as “ridiculous” doesn’t strengthen it.

              Reply
              1. graz

                How’s the coalition building going in your grass-roots movement? The one you like to think of as the “base.” Of course, aside from the Ron Paul followers you’ve adopted as aligned with whatever the so-called cause is, you don’t really expect to effect any influence beyond that? So why not belittle what would be your closest allies. Very noble indeed. Gandhi and MLK would likely counsel a different approach.

                Btw, you didn’t concede the Monday morning quarterbacking until after your tiresome sniping of everyone and everything that isn’t noble and pure like you.

                The previous is not gratuitous. Just telling it pure and true!

                Reply
  3. Steph

    Also, we don’t know how the Court is going to rule. We don’t even know it’s all in Kennedy’s hands. One problem with a focus on SC questioning, especially when it gets more into the public discussion that usual, is that people don’t realize that the Justices ask questions to flesh out the issues, not simply to argue a particular side. In that case about the strip search in school (forget the name, sorry), there was a ton of commentary about how horrifying the questions were where people just seemed to assume the questions indicated that they were going to rule in favor of the strip search. (Also, Stevens or Breyer told some anecdote about their own schooling that seemed weird.)

    I didn’t think the questioning in that case seemed at all unusual or inappropriate, and — as it turned out — the decision wasn’t close and was against the strip search.

    Here, one thing that is especially disturbing is the use of FOX News rhetoric and Scalia’s questioning in particular, as he really seems to have his mind made up and on something other than the legal issues and facts, but I can’t say I’m that so convinced about how the other 4 in question are going to vote or that there won’t be some kind of deal that we will find acceptable. (I have a strong suspicion with some, but more based on past positions and the like, not the questioning. Thomas, for example.) We simply do not know, and anyone who claims we do is really just guessing.

    Either Maddow or Hayes condemned the use of the SG’s argument, distorted and looped, in an attack ad, saying that it made it less likely that the Court would allow for the level of media accessibility allowed here in the future. Personally, I think it goes beyond that (bad as the ad is). When I see how politics are being played, and how people seem to jump to conclusions or freak about about normal questioning, I understand why the SC has concerns about media access. (And lower-level courts, also. Having the media coverage always changes things. It probably led to some of Scalia’s playing to the media that I perceived here.) When a tough question asked in an oral argument becomes an attack on legislation, as opposed to the types of questions we want asked in these kinds of cases, there is a problem. One thing the SC is supposed to do is explore the arguments made by both sides. Some of the questioning here did seem to me to raise concerns beyond the normal, but the freak out seems somewhat related to the politicization of this and some exaggerated assumptions about what we know. (To a certain extent, I think part of this comes from courtwatchers who made overly dismissive predictions in advance freaking out when they saw they were likely to be somewhat wrong and overcorrecting.)

    Reply
    1. Steph

      Oh, I should add that I don’t think just tossing the mandate would be so bad. It would require some strong behavior by the Dems, which is obviously a gamble, but it could end up a net positive.

      Reply
      1. Wonderment

        Wait! Tossing the mandate could be a “net positive?” Even giving you a lot of leeway to operate in the universe of the hypothetical, I’m skeptical about the world in which Obamacare does better without the mandate.

        Reply
        1. Don Zeko

          I’m with Wonderment on this one. ACA with no mandate isn’t stable: the chaos in the insurance market will force something to change, and I think it’s significantly more likely that this leads to the law being gutted than improved.

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        2. Steph

          I did not say that Obamacare does better as is, without the mandate. I said tossing the mandate wouldn’t be so bad. Clearly, Congress then has to act, but I am not so sure the action is to dump the whole thing. If the Dems don’t just go along with the idea that it’s all gone, but instead and fight to keep the popular parts of the law, like the requirement that we cover preexisting conditions and even some of the smaller things like coverage for adult children up to 26, it puts the Republicans in a position where they either have to kill popular things or cooperate to come up with a fix. It highlights why we needed the mandate (or something of the sort) and puts the Republicans in an awkward position of either being against benefits people like or screwing over the insurance companies.

          So who knows what actually happens, but there’s a lot more possibility than I think is being acknowledged.

          Reply
          1. Wonderment

            In other words, back to square one. Only this time it will be different.

            You’re right about different: The historic opportunities of 2009 (i.e. Dem. majorities and presidential popularity) are long gone.

            It’s better for Dems. if SCOTUS tosses “only” the mandate and not the entire ACA, but if it’s just the mandate, Republicans will still be dancing in the streets.

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            1. Don Zeko

              Well it’s not square one, because Congress will have to pass something. Getting back to the pre-2010 status quo requires congress to vote to repeal the whole thing, just as fixing the bill requires Congress to vote. That’s an improvement on the situation in, say, 2007, when the Republicans could simply block the bill and get everything they wanted.

              Reply
              1. Wonderment

                I wish you and Stephanie would be just a wee bit more upbeat about the marvels of ACA. Take your cue from James Carville. He is looking forward to SCOTUS trashing ACA and to soaring healthcare costs as the “best thing ever.”

                “I think that this will be the best thing that ever happen to the Democratic party because health care costs are gonna escalate unbelievably,” Carville told CNN’s Wolf Blitzer of a possible Supreme Court decision to strike down the law. “I honestly believe this, this is not spin.”

                It’s especially charming that he honestly believes it, as opposed to dishonestly believing it.

                Reply
                  1. Wonderment

                    Here’s my point in a nutshell so you don’t struggle: I think you tend to spin in favor of Dems, which puts you somewhat in denial about what a disaster ACA is.

                    Reply
                    1. Don Zeko

                      Well fair enough. I think you’ve let your frustration with Obama’s foreign policy and your irritation at being a marginal part of the Democratic Party turn off your bullshit detector whenever you read a criticism of the Obama administration, no matter how nonsensical.

              2. Steph

                Right. It’s harder to take away things than not pass them, and the Republicans have been trying to play this two-sided game where they talk only about the things people dislike (fears about Medicare, although that’s a bit ironic, and the mandate and, sigh, forcing you to pay for contraceptives), but ignore the relationship to that which people like, which they pretend to support. Without the mandate, the Dems could force them into a situation where they have to find a way to keep the good stuff or get blamed for taking it away.

                Reply
  4. claymisher

    Here’s a little homework problem: how much money will ACA redistribute? Follow the money (It’s not super easy to find out)

    Reply

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