Any day now the Supreme Court will issue its opinion on the constitutionality of the Accountable Care Act, which even the White House now calls Obamacare.
Most high-court observers think it will strike down the individual mandate in the Act that requires almost everyone to buy health insurance, as violating the Commerce Clause of the Constitution -- but will leave the rest of the new health care law intact.
But the individual mandate is so essential to spreading the risk and cost of health care over the whole population, including younger and healthier people, that some analysts believe a Court decision that nixes the mandate will effectively spell the end of the Act anyway.
Yet it could have exactly the opposite effect. If the Court strikes down the individual mandate, health insurance company lobbyists and executives will swarm Capitol Hill seeking to have the Act amended to remove the requirement that they insure people with preexisting medical conditions. They'll argue that without the mandate they can't afford to cover preexisting conditions.
But the requirement to cover preexisting conditions has proven to be so popular with the public that Congress will be reluctant to scrap it.
This opens the way to a political bargain. Insurers might be let off the hook, for example, only if they support allowing every American, including those with preexisting conditions, to choose Medicare, or something very much like Medicare. In effect, what was known during the debate over the bill as the "public option."
So in striking down the least popular part of Obamacare -- the individual mandate -- the Court will inevitably bring into question one of its most popular parts -- coverage of preexisting conditions. And in so doing, open alternative ways to maintain that coverage -- including ideas, like the public option, that were rejected in favor of the mandate.
The fact is, there's enough the public likes about Obamacare that if the Court strikes down the individual mandate that won't be the end. It will just be the end of the first round.
ROBERT B. REICH, Chancellor's Professor of Public Policy at the University of California at Berkeley, was Secretary of Labor in the Clinton administration. Time Magazine named him one of the ten most effective cabinet secretaries of the last century. He has written thirteen books, including the best sellers "Aftershock" and "The Work of Nations." His latest is an e-book, "Beyond Outrage." He is also a founding editor of the American Prospect magazine and chairman of Common Cause.
Follow Robert Reich on Twitter: www.twitter.com/RBReich
Wendell Potter: How Obama and the Democrats Got Played by the Insurance Industry on the Mandate
Of course I'm including any tax benefits the employer himself might receive for providing insurance, but I'm also suggesting that we need to begin treating the value of the employer contribution as income received by the employee. We could save billions every year if we took this simple step.
My own belief is that absolutely everyone who wants insurance should buy it on the individual market. No exceptions. No more subsidies for employer-sponsored insurance, no more special tax treatment for some Americans at the expense of other Americans. Individually purchased insurance may be more expensive--a great deal more expensive--and more unreliable than employer-sponsored insurance, but I believe if we make this simple, fundamental change, it will act as a bracing tonic for American individualism. And I don't see any section of the Constitution that says we should subsidize employer-sponsored health insurance.
Do I have support for this simple change from all the libertarians out there? All those who oppose the ACA? Are you with me?
Or are you going to hypocritically demand tax subsidies for yourselves?
Oh, that public support for ignoring pre-existing conditions for health insurance purchasers; it's one of those things the public supports until there's a discussion of what it really means. Say, "Mr President, if requiring health insurance companies to issue policies for those with pre-existing conditions is good, do you suggest we extend the principal to other kinds of insurance? Can I buy auto insurance after I've totaled my car or homeowner's after my house has burned down? Do you think the self-responsible people who buy insurance before a loss will pay the premiums needed to carry those who haven't?"
The Act is the Patient Protection and Affordable Care Act not.- as you state in the first sentence -the Accountable Care Act. In fact the Act does everything it can to avoid accountability. Giving free gifts to others like free abortions, abortifiacients and birth control, even to those with religious objections.
A little Freudian slip here, maybe.
The one fact of American jurisprudence, history, and the founding of the Republic that Democrats/liberals/progressives forget and disavow wherever they need to, or choose to, is this: the Constitution is the bedrock document, along with the Declaration of Independence, of the American experience. It sticks in their craw every time they're asked, or it's demanded, that they respect the Constitution (and its' limits on government) .... and few are guiltier of this than Barack Obama.
That's one reason he's going to be a one-term President; and he won't fully understand why, until one day when he actually reads the Constitution and says to himself, "Wow ... I really governed outside of the lines and the rule of law, didn't I?"
"Health insurance companies spent millions of dollars in an effort to prevent passage of the U.S. health care overhaul two years ago because they thought it would raise costs and disrupt coverage. Those companies have had their biggest profit margins since the recession began, according to a Bloomberg government study.
Insurance companies recorded their largest quarterly net gains of the past 10 years since the law was signed in 2010, said Peter Gosselin, the author of the study and senior health care analyst for Bloomberg government.
During that time, the Standard and Poor's 500 Managed Health-Care Index went up 36 percent".
-Deseret News Jan 2012
"In the midst of a deep economic recession, America's health insurance companies increased their profits by 56 percent in 2009, a year that saw 2.7 million people lose their private coverage.
The nation's five largest for-profit insurers closed 2009 with a combined profit of $12.2 billion, according to a report by the advocacy group Health Care for American Now (HCAN)".
-ABC news
Also read this commentary about how medical insurance companies make their profits.
http://www.timesunion.com/opinion/article/Insurance-companies-plans-ensure-profits-3612100.php
Congress, through it's power to tax, could have instituted a public option from the very beginning. And it would have been completely constitutional. BUt they did not want to do that.
Why?
Well, they did not want to pass a tax increase on the middle class, as this would have ended up. They TALKED about it. But they did not have the courage of their convictions to actually DO it.
Now, with the elections coming up a few months after Obamacare is tossed, do you really think that ANY of the Democrats will be talking about doing something that remotely resembles a tax increase?
No, they will not.
Face it. You had your chance, and you blew it.
Every Congressman can start buying votes by creating laws which mandate such things as buying a sandwich at Subway once per week or face IRS penalties.
Insurance companies have complicated risk models that they can adjust with the law changes. It's like trying to beat the house in Vegas. The game is rigged - they always take more off the table in negotiations and if the GOP is the negotiator for the government, they take all the chips for themselves.
Are you advocating the 'death panels' that the left told us would never happen?