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Wendell Potter

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Supremes Will Uphold Obamacare to Keep Insurance Market from Collapsing

Posted: 11/17/11 09:30 AM ET

Opponents of the Affordable Care Act who believe the Supreme Court will declare the law unconstitutional are going to be disappointed next year when a majority of the nine justices vote to uphold it. It will likely be a 5-4 decision, but moderate conservative Anthony Kennedy will, I'm confident, recognize that without the law, the free-market system of health insurance, so highly valued by conservatives, will implode, sooner rather than later.

The high court announced earlier this week that it will hear oral arguments on the constitutionality of the law next March. A decision is expected in June, just a few weeks before the parties hold their conventions. Regardless of which way the justices go, the decision will ensure that health care reform will be as contentious a campaign issue as it was in 2008.

Here's the reality. The provision of Obamacare at the heart of the constitutional challenge -- the requirement that all Americans will have to buy health insurance if they're not eligible for a public plan like Medicare or Medicaid -- is a "must have" for the nation's health insurance industry.

The plaintiffs who filed the lawsuits, including the attorneys general of 26 states, either haven't been paying attention to what's been happening in the private insurance market or have chosen to ignore it because of blind allegiance to ideology.

The indisputable fact is that our employment-based system of private health insurance has been crumbling for years -- to the point that potential new business for health insurers is, for all practical purposes, nonexistent. And ironically, it is their practices and policies, made necessary by profit-hungry shareholders, that have led to this state of affairs.

The only way the big insurance firms have been able to increase the number of premium-paying customers they actually want to insure is to "steal" market share away from each other or from smaller competitors. ("Steal" is their word, not mine.) The nation's largest insurers have become giants primarily through mergers and acquisitions, not through insuring people who previously were uninsured.

We got more evidence of the demise of employment-based health insurance just last week from a Gallup survey. It revealed that the percentage of American adults who get their coverage from an employer is continuing to decline, dropping to 44.5 percent in the third quarter of this year. That's down from 49.8 percent when Gallup started conducting the insurance surveys in 2008. The Employee Benefit Research Institute reported in a September analysis of insurance trends that the steady erosion of our employment-based system dates back to 2000.

The one bright spot in Gallup's most recent report was that the number of young adults with coverage actually increased during the third quarter of this year, undoubtedly because adult children, thanks to Obamacare, can now stay on their parents' policies until age 26 if they can't find a job that offers coverage. But finding a job that offers coverage is becoming increasing unlikely, of course, because the number of employers still offering health benefits keeps dropping.

One of the reasons for that decline is the common practice of "purging" (again, their word, not mine). Insurers routinely purge small businesses from their rolls when an employee gets sick and has high medical expenses. All it takes is one worker at a small company to get seriously sick or injured for an insurance company to jack up rates so high the employer has no choice but to drop coverage for all employees and their dependents.

Even if their employers continue to offer coverage, more and more workers are taking a pass because they can't afford their share of the premiums. This, plus the fact that insurers have refused to sell coverage to people with preexisting conditions, explains why the number of Americans without coverage now exceeds 50 million.

Insurers have continued to be profitable, but those profits will soon start to decline sharply because of another penny-wise but pound-foolish practice -- shifting more and more of the cost of care from them to us by moving us into high-deductible policies. Absent a mandate requiring that we purchase coverage, more and more of us will come to realize that these policies are not worth the premiums we have to pay for them.

A recent study by the Commonwealth Fund found that 30 million Americans are now underinsured as a result of being enrolled in policies that require them to pay more out of their own pockets for care than they can afford. Increasing numbers of those Americans are consequently resorting to another inefficient practice: foregoing needed care. In doing so, they are running the risk of needing more expensive care down the road.

The Republican candidates' alternatives to Obamacare -- tort reform, allowing insurers to sell their policies across state lines and shifting even more Americans into high-deductible plans -- simply won't fix these problems, as I have explained in previous columns.

So while the justices farthest to the right undoubtedly will vote to strike down the law for ideological reasons, the more pragmatic Justice Kennedy will recognize that the future of the free-market health insurance system rests completely on his shoulders. I believe he'll also realize that by declaring the mandate (and the entire law) constitutional, he not only will be saving the Republicans from themselves, he will be giving them a terrific gift. They'll be able to campaign with renewed (but insincere) vigor against Obamacare, arguing that it must be repealed. I say insincere because conservative candidates will want to keep their benefactors in the insurance industry happy after the 2012 elections. They're not serious about repealing the entire law -- just the parts insurers don't like. And with Kennedy's affirmative vote, the insurers will have what they need -- billions in federal subsidies to help Americans pay for the coverage the government says they must buy.

 
 
 

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Opponents of the Affordable Care Act who believe the Supreme Court will declare the law unconstitutional are going to be disappointed next year when a majority of the nine justices vote to uphold it. ...
Opponents of the Affordable Care Act who believe the Supreme Court will declare the law unconstitutional are going to be disappointed next year when a majority of the nine justices vote to uphold it. ...
 
 
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12:58 AM on 12/28/2011
My son is a political science student and tells me the same thing that this article states, "precedent makes this a no brainer under the commerce clause". He followed that with, " If congress has the authority to draft you into military service and take your life to protect the future of the country, it probably has the authority to compel you to take responsibility for the expense of your own healthcare".
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HUFFPOST BLOGGER
Miles J. Zaremski
Attorney, writer and commentator
09:45 AM on 11/21/2011
My colleague Wendell forgets to emphasize that it was the insurance industry that wanted the individual mandate; Obama wanted the public option. Wouldn't it be ironic if the high court voted down the healthcare mandate, leaving the insurance industry to flounder when faced with having to pay for all the new benefits ACA (affordable care act) provides yet not having the $billions to pay for them from the mandate while still maintaining a hefty profit margin. of course, the high court could strike down the entire act because the mandate is unconstitutional but that is highly unlikely. He is also correct as to who "butters its [insurers] bread", viz, the conservatives in Congress and on the court, so it is likely to see, as Wendell predicts, a sliver of a majority voting to uphold the mandate and ACA as a whole.
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HUFFPOST SUPER USER
moonlightesq
12:55 PM on 11/18/2011
The task of the Supreme Court is not to remedy a failed health system or resolve societal and economic inequalities, that is reserved for the legislative and executive branch of our government. If the Supreme Court justices made the decision to uphold Obama Care based on your reasoning alone, then they have failed their oath to properly interpret and apply our Consitution.
HUFFPOST SUPER USER
MissTake1989
Equal means equal, hypocrites.
04:51 AM on 11/19/2011
I saw an article in the WaPo the other day that offered 6 bullet point reasons why the Supreme Court should side with Obama's plan.

NONE of them involved whether or not the law was Constitutional or not.
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HUFFPOST SUPER USER
Charles Queen
I am a disabled nam vet
12:06 AM on 11/18/2011
No matter what the su[preme court decides,there is still a legal flaw in the bill thats going to keep it tyed up for a very lonbg time anyway's.Look it up,yes it's true.Also there's 2 member of the supreme court that need to be taken out of the equation anayways because of conflicts of interest
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Ice9
AZ: We're assumed guilty until proven innocent.
11:06 PM on 11/17/2011
"The nation's largest insurers have become giants primarily through mergers and acquisitions, not through insuring people who previously were uninsured."

They also refer to this as a "zero sum game". There are no new markets to be tapped domestically and any other developed country has a national healthcare system. The undeveloped world doesn't have enough wealth to attract American insurers.
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HUFFPOST COMMUNITY MODERATOR
Dosadi
Political agnostic
06:27 PM on 11/17/2011
Wendell you are about to spoil it. I really believe the only reason President Obama went with this plan is to force the Supreme Court to tell us that only single payer or universal health care is Constitutional.That will mean the end of the health insurance conglomerate and the start of the comeback of America. I know you know what you are talking about but don't let the cat out of the bag so quick.
04:52 PM on 11/17/2011
Interesting analysis. Informative article and even (so rare) some insightful comments in the thread.
ThePeacemakers
Concerned Citizen
04:47 PM on 11/17/2011
Mr. Potter, I'm surprised your article didn't go to "pending comments".

I've been saying much of the same.

But this precedent is about so much more than health insurance...
Many gullibly swallow it as a plan, but the Citizens United case should have let them know how dangerous it is to set this kind of precendent (mandates to purchase a product - FOR LIFE - from a private corporation) when politicians in the beltway will be more bought off than ever.
04:23 PM on 11/17/2011
Also, Justice Thomas needs to be impeached if he doesn't recuse himself.
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HUFFPOST COMMUNITY MODERATOR
Dosadi
Political agnostic
06:27 PM on 11/17/2011
He needs to be impeached even if he does recuse himself.
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HUFFPOST PUNDIT
jamaicalover
Team Obama
03:47 PM on 11/17/2011
Great article!!! Please continue to speak the truth about America's healthcare problem. Money and 50 million uninsured Americans.
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mtwa
03:40 PM on 11/17/2011
When we found out there was to be no public option in healthcare, I knew this was about nothing more than making big insurance business' richer. That is exactly what it does. Forcing everyone to buy their product. Nothing changes but that basically. Just think about it.
06:01 PM on 11/29/2011
no that not what it does for the first time you have the power to hold those greedy people accountable by having them pay 80to 85 cents on the dollar it directly encourages you to cut excessive medical use from the budget by refunding to you the difference. your persuit of the perfect in lew of the better defeats the very purpose of reform
03:11 PM on 11/17/2011
Why don't we discuss the emergency medical treatment & active labor act EMTALA in the same context. If it's OK to force hospitals to cover uninsured people why is it not OK to make people buy insurance?
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HUFFPOST PUNDIT
jamaicalover
Team Obama
03:47 PM on 11/17/2011
I've been saying this for two years.
04:17 PM on 11/17/2011
I agree completely. Universal healthcare has existed for years. Reagan signed it into law. "Obamacare" just seeks to deliver it in a more sensible way.
HUFFPOST SUPER USER
MissTake1989
Equal means equal, hypocrites.
02:55 PM on 11/17/2011
IF Obama had fought and won a single payer health system...

AND one year later, the GOP and Blue Dogs joined together to pass an NRA backed bill that required EVERY American to purchase a firearm...

All of the liberals who are defending the health care law and all of the GOPer's who are opposing it would be espousing the EXACT OPPOSITE positions regarding the government's power to "mandate."
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HUFFPOST PUNDIT
jamaicalover
Team Obama
03:49 PM on 11/17/2011
I like single payer. The only problem is...Americans without jobs won't be paying into single payer.
04:21 PM on 11/17/2011
The problem with your analogy is that first there would have to be armories in every city where the government forced gunmakers to give away a firearm to anyone who needed it.

We have that now with healthcare. It is called EMTALA and Reagan signed it into law.
HUFFPOST SUPER USER
MissTake1989
Equal means equal, hypocrites.
05:42 PM on 11/17/2011
It's not an analogy.

Congress either has the power to mandate or it does not.
02:54 PM on 11/17/2011
Mr. Potter, according to Gallup's own website explaining the data you cite in your blog, "There are two major forces that are affecting where Americans get their health coverage: One is President Barack Obama's Patient Protection and Affordable Care Act and the other is high unemployment and underemployment." While I appreciate your view, I would submit that the second force, high unemployment and underemployment, has been a much larger contributor to declining membership in employee based private insurance. Fix the economy and the private insurers will be healthier than ever. No court intervention required. Therefore, Justice Kennedy rules "Unconstitutional".
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HUFFPOST PUNDIT
jamaicalover
Team Obama
03:50 PM on 11/17/2011
before the great recession of 2007-present 30 million Americans were uninsured. And not all employers offer coverage.
10:00 PM on 11/17/2011
Not commenting on the appropriateness of employee based private insurance as the preferred system. Just pointing out the flaw in Mr. Potter's argument that Justice Kennedy will judge constitutional.
HUFFPOST SUPER USER
Anne Rutherford
04:00 PM on 11/17/2011
The number of employers offering health insurance has been dropping steadily for years as premiums and exclusions have increased. There is no particular reason in the world to tie health insurance to employment, unless perhaps, we were to do what Germany does - and make the policy portiable through every other employer you ever have, but this country isn't set up to that. Kennedy will rule it constitutional.
10:09 PM on 11/17/2011
At the risk of sounding condescending, I like the way you think Anne. Unfortunately, there is a reason why we have health insurance tied to employment. Wait for it...Unions! Actually, to be fair it's a little more complicated than that. This link is a fairly accurate synopsis http://www.ehow.com/about_6583821_history-employer_based-health-insurance.html Oh, and thanks for the blurb about Germany's system, I was unaware of that.
HUFFPOST SUPER USER
MissTake1989
Equal means equal, hypocrites.
02:53 PM on 11/17/2011
Not one word in this article was used to consider whether the law is unconstitutional or not.

Not one.

We need health reform. That doesn't make the law constitutional.

Employer based coverage is eroding. That doesn't make the law constitutional.

The private market is too expensive for most people. That doesn't make the law constitutional.

The uninsured raise costs of others. That doesn't make the law constitutional.

The GOP has no alternative. That doesn't make the law constitutional.

It was a GOP idea. That doesn't make the law constitutional.

Single payer is politically unattainable. That doesn't make the law constitutional.

While acknowledging that the Court often get it wrong...and often for ideological reasons...often for greed...

This law IS unconstitutional.
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SonicUltimate
05:13 PM on 11/17/2011
"The uninsured raise costs of others. That doesn't make the law constitutional."

Actually, that is exactly what makes it Constitutional.  If the uninsured are raising costs Congress has every right to tax the uninsured based on that status to cover the increased costs.
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MissTake1989
Equal means equal, hypocrites.
05:39 PM on 11/17/2011
Agreed.

They have the right to tax.

Too bad they passed the unconstitutional mandate rather than a legal tax.
05:25 PM on 11/17/2011
Stating again and again that the law IS unconsitutional...does not make it unconstitutional (ok, double negative, but the point is, tell me WHY it is unconstitutional, and we can debate THAT point). Simply stating something as a fact when it is anything but is a poor argument. The constitution is a brilliant and fickle document, open to interpretation. I know, shades of grey are hard to comprehend when you think only in black and white, but please try...
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MissTake1989
Equal means equal, hypocrites.
05:40 PM on 11/17/2011
Commerce clause allows for the REGULATION of commerce...not the compulsion of it.