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Ethan Rome

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Supreme Damage: Why the Court Can't Throw Out Obamacare

Posted: 04/20/2012 12:22 pm

The Supreme Court will uphold the Affordable Care Act (ACA) not only because it's constitutional, but because to do otherwise would impose a massive judicial intervention in one of the economy's most complex sectors and derail a train with millions of individuals and businesses on board.

If the conservative justices disregard decades of legal precedents and strike all or part of Obamacare, they would not merely be tearing down the most sweeping piece of social legislation since Medicare and Medicaid, they would be taking away substantial consumer protections and benefits from millions of America's seniors, families and small businesses. The court would have to take responsibility for dismantling the law piece by piece, a task as difficult as it is unconscionable.

The law is two years old. Implementation is moving forward, and hundreds of complicated provisions are in effect, helping millions of Americans. States, businesses, doctors, hospitals and insurance companies have undertaken major, costly changes in anticipation of the improved insurance marketplace developing right now. All of this has been happening despite the relentless assault by Republicans who want to strike the law dead.

The fact is that serious wreckage would result from a bad decision. Attempting to unscramble this omelet would be a national nightmare.

How would the conservative justices implement such a devastating decision? What would they leave in the law's place? For example, when would the 2.5 million young adults who are on their parents' insurance plans because of the law get dumped into an insurance market that won't sell them affordable, quality coverage? What about the prescription drug discounts for seniors? Nearly four million Medicare beneficiaries saved more than $2.1 billion on prescription drugs in 2011 alone. When would those savings be terminated?

Preventive health services are now provided without co-pays in all new insurance plans and through Medicare. More than 86 million Americans are already benefiting. When would this benefit be stripped away? How would providers keep track of who gets it and who doesn't and when? Would lifetime limits on insurance coverage be reinstated? When and how? Would that cause changes in the pricing of health plans already being formulated? What about the job-creating small business tax credits -- when and how would they be taken away?

But that isn't all. Consumers are slated to get as much as $2 billion in rebates this summer from insurance companies that spent too little on medical care and too much on profit, administration and CEO salaries during 2011. Would the insurance companies get to keep that money instead of returning it to the consumers who got a raw deal?

How about the 50,000 people in the Pre-Existing Condition Insurance Plan (PCIP)? Spike Dolomite Ward learned about the health law when she was diagnosed with Stage 3 breast cancer. She was uninsured and had no way to pay for life-saving chemotherapy treatments until she enrolled. She has affordable insurance today through the PCIP -- a plan no insurance company would sell her. If the justices are going to revoke this life-saving coverage, when and how will they do that? Would she have to cancel her next chemotherapy treatment and hope that the cancer goes away on its own?

As Ian Millhiser pointed out during the oral arguments, if the court were to throw out the law "the result will be bedlam." He gives other important examples of the chaos that would ensue here.

Opponents of Obamacare, such as the Republicans in Congress, don't care about the train wreck that would follow such a decision, just as they don't care about doing anything to make health care more affordable and accessible. Two years of rhetoric later, they still have no ideas on what they'd replace the ACA with. Mitt Romney, the presumptive Republican presidential nominee, even has disavowed his own best idea for health care reform. It's called Romneycare, and it's the Massachusetts law that served as a model for Obamacare.

Because opponents of the law have no authentic policy alternatives to the Affordable Care Act, that brings us back to the Constitution. It does not serve them well here. As Senior Judge Lawrence Silberman of the D.C. Circuit U.S. Court of Appeals wrote in his decision upholding the law, the opponents of Obamacare "cannot find real support" for their challenge "in either the text of the Constitution or Supreme Court precedent."

The justices are supposed to act judiciously, respect precedent and not assume the policymaking role of Congress. It is for these and other reasons, explains Jonathan Cohn, that Silberman and four other prominent, respected main-line conservative judges and legal scholars argue that the Affordable Care Act is constitutional. Deeply conservative Columbia University constitutional law professor Henry Paul Monaghan says the law is valid based on "settled judicial principles."

If the justices ignore the Constitution and strike down this law, the result would be significant human pain, legal mayhem and economic disruption. They should be moved by the consequences of their decision, rule on the merits and uphold this law.

 
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The Supreme Court will uphold the Affordable Care Act (ACA) not only because it's constitutional, but because to do otherwise would impose a massive judicial intervention in one of the economy's most ...
The Supreme Court will uphold the Affordable Care Act (ACA) not only because it's constitutional, but because to do otherwise would impose a massive judicial intervention in one of the economy's most ...
 
 
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02:07 PM on 04/24/2012
Actually this is all part of a longer term demographic shift here which is taking away the very minimal freedom of normal middle class people to at least have the opportunities to take risks / aspire to become job creators (live the American dream), to instead concentrate wealth and power in a narrow band of people and corporations, the so called job creators.

This band will get more and more wealthy and the rest of us will not even be able to dream of taking risks and will just get squeezed more and more. Unfortunately this band of people and corporations are also getting constantly better at selling their agenda to the public, and getting many many people to work against their own interests.

The average citizen these days is living in constant fear of getting sick, getting fired, losing their home etc. and that fear will only continue to rise in this society. Unfortunately this fear is also going to retard progress (free minds and unfettered societies are a prerequisite for real growth and innovation) , thereby creating a vicious cycle of increasing disparity and societal decline.
11:31 AM on 04/24/2012
Do we really think that SCOTUS operates on the terms of a leftist blogger? Not really, the simple truth is that the judges are likely taking the time to read the act - something which which Congress did not do.
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woodrow2012
"An Independent Man of True Grit"
07:35 PM on 04/23/2012
What is the difference between Obamacare and Medicaid? Under Medicaid, don't the lower income people can get health care?
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HUFFPOST SUPER USER
Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
10:14 AM on 04/23/2012
How might the Court be held accountable if they threw out Obama care and caused bedlam in economic markets, prompted another resession, and people died as a result? How much mayhem must they let loose before they're all impeached, and wouldn't that just lead to more chaos?
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08:21 AM on 04/23/2012
Trying to find the logic to any decision the SCOTUS makes is pointless. In this case the 4 neocons will vote the way they deem will enhance rightwing ideology.
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woodrow2012
"An Independent Man of True Grit"
07:25 PM on 04/23/2012
And the other 4 judges will vote with their leftwing ideology. The key is to how Kennedy will vote since he is an independent.
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woodrow2012
"An Independent Man of True Grit"
05:42 AM on 04/23/2012
If the Supreme Court finds this constitutional, will Obamacare hurt the insurance companys? The insurance industry has a lot of employees. I hope people won't lose their jobs. We surely don't need that!
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woodrow2012
"An Independent Man of True Grit"
05:18 AM on 04/23/2012
This will be an "Affordable Health Care Act". But how bout the people with a history of drug use, alcoholism, DWI's, and a variety number of arrests including felonies? Under normal circumstances, the insurance company's premiums would skyrocket, and that's IF you could get a policy. So if Obamacare gets passed, will it still be "affordable" for them too?
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Fred Gingerale
02:11 PM on 04/22/2012
The mandate will most likely be found unconstitutional, as it should be. The law as a whole going down is much less likely, but judging from the court arguments a real possibility. Either way, nothing will change, people will still get their health care, whether they can afford it or not, the sky won't fall, the wolf won't bite and time marches on.
09:55 AM on 04/23/2012
My belief is that if Roberts comes to Kagan and/or Sotomayer with a 5 person majority and the decision to scrap the entire law, that he can convince one of them to side with him to make it 6-3 in exchange for only dropping the mandate and the 2 other parts tied to it.
11:38 AM on 04/24/2012
Just think, the Conservatives can use the act to force the Leftists all over America to do things if they ever gain control of the three houses. It could be great fun for the Republicans.
06:24 PM on 04/24/2012
Three branches, rather - *drinks coffee* Not that it matters, anyone that thinks they predict SCOTUS rulings is pretty much insane.
02:50 PM on 04/21/2012
What a bunch of "feel good" tripe. Even if it passes, it will change almost nothing. As a small business owner, as soon as I am forced to pay for health insurance for my employees, each one of them will get a commensurate pay cut. Those companies that can't or won't do this will pass on the costs to the buyer of their goods and services. Most companies are not running with giant profit margins. These are tough times and many businesses are just scraping by. I know literally hundreds of business owners, large and small, and there isn't one of them I have spoken to who isn't planning to do what I just said. And the ones that follow the law and take the full brunt of the costs on themselves will be competing in a market where their costs are higher thereby increasing the chance they will fail and contribute to the unemployment numbers.

I'm just thinking of the conversation I might have with my employee if this awful law passes:

Me: Congratulations, Brenda. Fill out these forms and get your "free health care."
Brenda: Thanks
Me: Oh, by the way. I can only afford to pay you $60,000.
Brenda: I know. That's my salary.
Me: Well, that WAS your salary. Since this healthcare plan is costing me $6,000 a year, your salary is now $54,000.
Brenda: That's ok. I know I'm helping millions of poor folks and that is payment enough.

Yeah, right?
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woodrow2012
"An Independent Man of True Grit"
05:06 AM on 04/23/2012
Great comment. I have never looked at it this way, but I'am sure this will happen. So, in retrospect, we will have another one of Obama's polices that will hurt the middle class. This was beautiful Ferguson !
09:56 AM on 04/23/2012
Sames as the "free birth control". It will cost in insurance premiums, and then like anything where the people don't have to bear the cost and make choices based on price, the actual cost will skyrocket.
01:56 PM on 04/21/2012
Ethan,
Is one suppose to take you seriously based on your place of employment and those organizations that support your cause? All those that support Health Care for America Now will gain under Obamacare...It's not ethical of you to write an article about the Constitutionality of a very Unconstitutional bill (using sob stories as examples) only to benefit financially from the outcome.
05:43 PM on 04/25/2012
You could click the links and take the word of the multiple conservative judges and proffessors who've alerady said that this law is absolutely constitutional. They aren't employed by this media outlet. What excuse will you use for not arguing that topic and arguing the messenger instead then?
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marignymitch
E pluribus unum percent
12:42 PM on 04/21/2012
Yes, but in Oct 2000 most Americans thought that the Supremes couldn't upend a presidential elections and appoint the (disastrous) candidate of their choice.
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woodrow2012
"An Independent Man of True Grit"
05:08 AM on 04/23/2012
The Supremes haven't had a hit song on over 30 years!
12:36 PM on 04/21/2012
Woo Woo! Train wreck should be in about ten weeks now.
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CollectiveNotIndividual
09:47 AM on 04/21/2012
Supreme Damage: Why the Court Can't Throw Out KidCare. America inequality continues to grow. The problem...smart women procreate with smart men....and dum women procreate with dum men. Obama's new KidCare law will correct this problem...but forcing smart women to mate with dum men. We can create equal intelligence if we allow this program to run its course. The supream court must not throw out this law...cause think of all the good it will do !!
09:23 AM on 04/21/2012
- After having actually READ much of the legislation and provisions of PPACA (Patient Protection and Affordable Care Act), and having had time to digest the terms foisted upon the American public, one cannot help but realize that this 'pig in a poke' is any but what its name proclaims.
- As with many governmental namesakes, it is a complete and utter oxymoron. It would be better defined as the 'Personal Property Appropriations Commandeering Act'. The 'legislators' putting this 2700 page volume together are having tremendous difficulty funding all the promises they've made to keep their privileged positions.
-The purpose of this legislation is to solely to create a new tax spigot to suck funds from the American public. Although there are a few 'benefits' mandated to make the people believe they are actually getting 'something' this legislation was definitely NOT designed to assure that the public will receive better care, and worse still, as costly as coverage was BEFORE, this legislation is designed to drive the costs of coverage higher than ever and to assure that LESS care is received..
09:57 AM on 04/23/2012
no, no, no, you are entirely wrong. Its not a tax spigot, its an insurance company bailout. They get an enforced large amount of new people as customers free, and they are "limited" in profit/costs at a higher percentage than they've made in the past without a limit.
05:41 AM on 04/21/2012
If the 5 "Corporatist Supremes rule against the individual mandate, there will be a huge, monstrous, gigantic push to go to Medicare for everyone - and it will succeed.

More and more people are coming to understand the devastation healthcare costs have wreaked on this country. There are a few who haven't been touched by it yet or they're getting their healthcare paid for by someone else - like American taxpayers.

Medicare works - and it doesn't cost billions in CEO bonuses and stockholder dividends which takes away money from actual healthcare. Less than 3% of Medicare funds annually are for administrative purposes. Contrary to what the liars (aka Republicans) say, it's a pretty effiicient system.

Just think how low premiums would be if everyone in the country paid into one system - and think how much better your healthcare and probably your health would be because of that. Less cost for all preventative medicine - a huge factor in the cost of healthcare premiums now.

It would also have the side benefit of creating more jobs in the healthcare industry. There are going to be people who refuse to see it, but Medicare for everyone is one of the smartest things this country could ever put into effect.