Monday, July 16, 2012

How John Roberts killed the Affordable Care Act, continued

Me, last month:
Now. I doubt Republicans would mount a campaign to get everybody to pay the tax and avoid health insurance in order to undermine the purposes of he Affordable Care Act. But if the mandate is now framed in the popular mind as a "cheap tax I can pay" instead of a "rule that I must follow," it's possible that many young, poorly paid people will opt to pay the tax--and that insurance companies will drown over time as a result.
James Capretta and Yuval Levin, today at National Review:
In the wake of the Roberts decision, participation in Obamacare’s insurance scheme is optional. Rather than a requirement to buy coverage backed with a penalty for violators, the law now offers Americans two equally lawful and legitimate options: buy expensive insurance (which Obamacare will make all the more expensive), or pay a modest (and still largely unenforceable) tax and just buy insurance for the same price later if you need it. Presented as a choice, not a command, this provision will invite a straightforward comparison, and for many Americans the choice it would pose would be a very easy one. 
Obamacare was always going to lead to a disastrous meltdown of America’s health-insurance system, but in the wake of the Court’s decision, many of its former defenders should acknowledge this fact too. If you argued that the mandate was the linchpin of the system, and that it would work despite its low and unenforceable penalty because Americans are a law-abiding people, you should now see that the mandate as you understood it no longer exists.
So prepare yourselves for the next battle--probably about 10 years from now. It'll probably be a choice between scrapping Obamacare entirely, or replacing it with a single-payer system. I don't imagine that battle will be any easier for liberals than past ones have been.

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