Four comments on yesterday’s Supreme Court decision on Obamacare:
First, as I said two years ago when Obamacare passed, I think a good argument can be made that it was good the Affordable Care Act was not overturned by the U.S. Supreme Court. I am not sure certain parts of the Democratic/liberal/progressive side could have handled such a decision with appropriate restraint (given, for example, President Obama’s hissy fit over the Citizens United decision), and I am not sure it would have been good for the stability of our country.
Also, those who wanted the Supreme Court to overturn Obamacare, or at least the individual mandate, because they didn’t like it as policy were misunderstanding the role of the Supreme Court. It is not a legislature of last resort (though some liberals/progressives seem to think it is, at times). The Supreme Court’s role is to enforce the rules we have set for how our system is to operate. It does not make policy; it protects procedures.
Second, based on the cursory news reports I have read of Chief Justice Roberts’ opinion, I am very happy with it. By basing his upholding of the individual mandate on the taxing power, he may have expanded the taxing power somewhat. But by refusing to base his opinion on Congress’s power to regulate interstate commerce power, and by specifically saying that Congress would not have the power to impose the individual mandate under the commerce clause, he has taken another step down the road of setting limits on the federal government’s power under the commerce clause. This is very important.
If the individual mandate had been upheld as a valid exercise of Congress’s power to regulate interstate commerce, then there would be no significant limit on the federal government’s power under the commerce clause. The federal government could do whatever it wanted on almost any subject it wanted. There would be no real limits on the federal government’s powers, either vis-à-vis the states or the people. But from what I have read, Chief Justice Roberts did say there were limits to the federal government’s powers under the commerce clause, and by doing it in a case that approved Obamacare (instead of striking it down), he did not give liberals/progressives the easy foothold to oppose the limits. They won the case; why are they complaining about the reasoning?
Third, and tied in point two, I like that part of the decision that struck down, by a 7-2 majority, the section of Obamacare that tried to blackmail the states into accepting Obamacare’s expansion of Medicaid by threatening to withhold all of the money that states are already getting for Medicaid if they refused to go along with, and pay part of the cost of, the federal government’s proposed expansion of Medicaid. This could wind up being a significant limit on the federal government’s ability to force the states to do what the Feds want by threatening to withhold money. Believers in federalism have to be happy with this part of the decision. I don’t see how big government Democrats/liberals/progressives can be.
Fourth, I understand that Obamacare is still around. But within five to ten years, I do not think it will matter. Obamacare is incredibly complicated. (I once compared it to a Rube Goldberg invention, which is unfair to Rube Goldberg inventions because they work.) Under the law one group gets healthcare coverage one way while another group gets it in a different way and a third group gets it a third way. Very complicated. And with the attempted forcing of states to participate in the expansion of Medicaid thrown out, who knows how many of those people will get coverage or how that coverage will be paid for.
Certainly, experience with provisions of the law that have gone into effect has not been good. Cost estimates of particular provisions have been wrong. Estimates of the numbers of people that would be served by other provisions have been way off. And if estimates and projections have been so wrong on small things, why should there be any confidence on what the law’s proponents have told us on how the rest of the law is going to work?
The law is not going to work as we have been told it would. It will need to be replaced or changed so much that it will unrecognizable. Or we will be left with a healthcare system worse than the one we have now. Which may be my scariest comment about the decision. But that is a comment on the law, not on what the Supreme Court did.
Comments