As the day draws closer to the Supreme Court (SCOTUS) announcement regarding the Affordable Care Act (ACA), the speculation over what it will be and what the reactions of the various stakeholders will be grows more intense. And while this may be a great parlor game, it is not helpful for that ultimate question that will follow the decision -- "Now what?"
Washington can be a short-sighted town where stakeholders too often only think about and map out a few steps forward in advancing an agenda. For those who have lost political or legislative battles, they often don't even look that far forward. They look backward to fight the last battle.
Regarding health care, this would be a mistake. To date, much of the rhetoric has been around how the Court should rule. For Republicans, they are calling for the entire law to be thrown out as a drastic overreach or barring that at least the individual mandate should go. Democrats, on the other hand, talk only of the current benefits of the law and try to avoid any discussion of what should be done if the Court rules against the law.
Herein lays the problem. In a recent AP-GfK survey of Americans, 77 percent of those surveyed believe that if the SCOTUS rules the law unconstitutional, "the president and Congress... should start work on a new health care reform bill" while only 19 percent said they should "leave the health system as is." The message is clear: the public, despite not supporting the new law, want their government to address the problems in our health care system. According to the AP-GfK survey; opposition to the law has been relatively consistent, ranging from a high of 52 percent to a low of 42 percent since December 2009; while support has ranged from a high of 45 percent to a low of 29 percent, also in the same time period. And as the survey seems to indicate, if this is not the law to address the problems in our system, the Congress and president should find other answers.
But the rhetoric coming from both sides indicate that this is not what an aftermath of any SCOTUS decision will look like.
A strategy to "re-litigate" the ACA and the politics surrounding it will not satisfy the public, according to the AP-GfK survey. If found unconstitutional, the public wants a "new health care reform bill."
It would be nice to see Congress and the president listen to the public. Don't hold your breath.