The following editorial appeared in the Chicago Tribune:
For three days this week, the U.S. Supreme Court has slapped on the table a serious possibility that defenders of the Patient Protection and Affordable Care Act never envisioned: A ruling that the heart of the law — a mandate that all Americans buy health coverage — is flatly unconstitutional.
Judging from the line of skeptical questions fired by the justices, we can count as many as six potential votes to kill the mandate.
The court may go much further. On Wednesday, several of the court’s conservative justices suggested that they are willing to strike down the law entirely, including its massive Medicaid expansion.
“One way or another, Congress will have to revisit it in toto,” Justice Antonin Scalia said of the health law.
One way or another.
That should be a clarion call in Washington. The prospect that the court will strike down all or part of the law known as Obamacare hands political leaders of both parties a formidable challenge — and a vast opportunity: a second chance to get health care reform right.
The law isn’t scheduled to fully kick in until 2014. Plenty of time for a reset — a reset that both major parties have an obligation to deliver.
Democrats have been assuming that the law would be upheld by the court and that the American people would come to love it as they learned about it. Neither seems likely now.
Republicans have been chanting, “Repeal and replace.” But now there’s more urgency behind the question: With what? Republican pols came up with several smart ideas during congressional tussles before passage of this bill two years ago, but those never gelled into a coherent, compelling and competing bill.
The court is expected to rule in June. Between now and then — and possibly after the justices rule as well — Democrats and Republicans have a choice: They can continue to cast blame on one another but otherwise dodge this issue until after November’s election. Or they can dwell on the millions of Americans who need health care coverage.
Politicians of the first persuasion, who see the upcoming ruling as nothing more than ammunition for election-year attacks, invite voters to show them the door. What problems are they solving?
We instead hope that lawmakers — Democrats chastened by the court’s skepticism, Republicans who now have to deliver an alternative to Obamacare — will work together toward a bipartisan health care reform law. A law that carefully and affordably expands care.
Obamacare failed to do that. Instead, Americans got a law shoved through Congress by Democrats. A law that required an array of especially noxious backroom deals — Remember the “Cornhusker Kickback” to bribe a Nebraska senator? — to gain the required votes. A law whose unaffordable price tag was intentionally disguised by the sponsors’ accounting gimmicks and smoke-and-mirrors projections.
That’s a big reason why many Americans still don’t like the law.
Every politician in America — President Barack Obama and the Republicans campaigning to replace him included — should be ready for this question: The Supreme Court — or the next Congress — could kill Obamacare. What are your ideas for a better way to expand coverage without breaking the bank?
Republicans: “Told you so” isn’t an answer. You need an understandable and solutions-oriented explanation of the “replace” in “Repeal and replace.”
Democrats: “Obamacare minus the mandate is just fine” isn’t a solution. The mandate was part of the law’s central bargain: Everyone would buy coverage, and in exchange, insurance companies would cover all Americans, regardless of pre-existing conditions. Without the mandate, health premiums soar or insurance companies collapse. That’s unhealthy for all Americans.
Our goal here isn’t to predict the court’s decision. It’s to assure that whatever the health reform law’s fate, political leaders of both parties promptly respond with the best possible plan.
It will be hugely embarrassing to Obama and his party if the court strikes down the signature achievement of his presidency. But if that happens, he should respond with Plan B — and this time, don’t trust the law-drafting entirely to Congress.
Remember how Obama gathered Republican and Democratic leaders for a televised health care summit in 2010, in what he billed as an attempt to share the best ideas for reform? In the end, the Republican ideas wound up on the cutting-room floor. Democrats didn’t just squander many good proposals. They turned health reform into a purely partisan exercise.
That said, Obama’s Republican challenger will need more than slogans to convince voters. He’ll need a realistic rationale for why his alternative plan will attract Republican and Democratic votes on Capitol Hill.
Lawmakers, candidates: Don’t wait to see if the court really does hit the reset button. Start the debate now.
Americans are listening. And expecting you to perform better than you have in the past.
Comments (24)
Add commentIt is amusing that a self
It is amusing that a self proclaimed "constitutional scholar" will very likely have his signature achievement tossed out by the SCOTUS.
But what ever the federal government does after ward, it should keep in mind that individual liberty is paramount.
Politics
The SCOTUS rules in June. Wait until then for Plan B.
Almost certainly they'll rule along partisan lines. If the Act gets shot down, this will be a great campaign point for Obama. He can point at this decision and Citizen's United as very compelling reasons why he needs another term so he can ensure balance on the court.
Can you imagine what a disaster another Thomas or Scalia on the court would be? The corporate takeover of our country would be complete. If for no other reason, that would be a reason to vote for Obama.
As far as healthcare, implement what's working successfully around the world - a single payer, universal system. Extend Medicare to everyone and fix its flaws.
Right on
Latitude 58
@Lat58
I think you meant Medicaid -- the freebie
Fundmental issue is
the need for some HC program in the US. You can banter back and forth all day about Obamacare and its constitutionality and it does not answer the fundamental issue: is there a need for national HC.
I for one doubt the SCOTUS would ever support any notion that those who can not pay should be allowed to go untreated. So how would SCOTUS describe how to pay the cost for HC for those who can not pay.
The only for certain thing today is those who are paying directly through insurance, direct pay or some other means are all paying the cost of the uninsured. Indirectly those who pay taxes at the state or federal level find some obscure part of your tax dollars are paying for the uninsured.
affordable access to insurance
The SCOTUS opinion in June will do more than rule on Obamacare – it will address the federal govt’s role in regulating commerce. Because that issue is at the heart of the Dem’s justification for it, just like the opposing side’s aversion extrapolates that if Obamacare is vindicated then where does Congress draw the line on commerce?
As far as replacement, it seems that the nexus for health care & commerce lies in INSURANCE. “Affordable Health Care” is a misnomer. Obamacare’s objective is affordable healthcare insurance. The answer is not spread-loading a cancer to more participants; attack the cancer. Don’t get me wrong, insurance is a necessity, but it is extremely susceptible to abuse – a perverse ponzi scheme where the big payoffs are in litigation and among the poolees are doctors scared of frivolous malpractice suits, insurance companies forced to raise policy coverage to stay viable, and participants with pre-existing conditions paying exorbitant premiums, co-pays, and deductibles.
tea
& Proud of it
1) The ACA is better than our
1) The ACA is better than our previous system in that it allows more people access to healthcare, particularly those who need it the most.
2) Republicans have yet to come up with a viable alternative, despite having bitched and moaned about the ACA for the last 2 years.
3) Ergo, Republicans should STFU. They had their chance to propose a better alternative and blew it (probably because the ACA WAS their alternative plan to single-payer in the 90's).
@pp -- GOOOD morning
rewind to when this ACA was being spawned in the House. It was a behind-closed-doors deal that effectively cut the GOP out of the process. Now it's law, and SCOTUS is evaluating the validity of it.
So at what point in the process from the spawning grounds, through the filibuster-proof Senate, and to Obama's desk did the opposition have a voice? I missed it on C-SPAN, but that's another issue.
Back to the "Now it's law" -- why spend time on would'ves/ should'ves until there's a reason to spend time?? As long as it took to breach-load Obamacare, it is a waste of time to discuss alternatives until SCOTUS defines what Congress CANNOT do.
"They had their chance..." Get real.
Awww, poor baby. Making
Awww, poor baby. Making excuses for his dishonesty! We all know that "repeal and replace" really amounts to "repeal and distract."
The ACA is law. There is nothing preventing a new, better law from being instituted. Therefore, there is no excuse for your constant, vacuous criticism.
Furthermore, if you know anything about politics at all, you know that the ACA was, itself, a compromise, because the Democratic party is not so cohesive as the Republican party (read: it's not a club for white guys united by hatred of the "other") and embodies a more diverse range of political views and opinions. Obama's real mistake? Trying to compromise with the GOP at all, given their admitted stance in opposing him just for the hell of it.
For the "party of personal responsibility," you sure spend a lot of time blaming everyone else for everything.
@pp
1. you're being caustic and presumptuous again. You need to keep that in check if this turns into another tantrum;
2. You said it was a compromise? I'm taking you to mean an inner-party compromise. That still strikes me as myoptic...
3. But you shot a hole in your own argument [note: HERE is the proper place to insert disparaging personal attack -- at the end of a point. Otherwise you come off as contemptuous];
4. "There is noting preventing a new, better law from being instituted." Yes there is: POTUS.
"Obama's real mistake? Trying to compromise with the GOP at all, given their admitted stance in opposing him just for the hell of it."
Now why would a sitting president, whose only "achievement" has been a massive revamping of the healthcare industry, sign a law that would present a better alternative, even if it had massive BIPARTISAN support from both houses and massive support from the people? Oh, and it would strike his one achievement in the process.
He wouldn't; he won't. It's a waste of time to do anything until SCOTUS delivers an opinion that defines what can and what cannot be done here. Otherwise, presenting an alternative falls on deaf ears.
@Grendel: the ACA is
@Grendel: the ACA is essentially what Mitt Romney passed in Massachusetts, and is essentially what Republicans suggested in the 90's as an alternative to single payer. SOUNDS LIKE A COMPROMISE TO ME. (note: when I speak in capitals, I'm mocking you by stating something obvious you refused/neglected to understand, I'm not yelling at you all angry-like)
And you completely shoot down your argument's credibility by assuming that the president wouldn't accept anyone else's healthcare law. See, this isn't really about healthcare. This is about you not liking the president. That's why you automatically assume he'll play the villain if Republicans were to actually do their job, and this assumption allows you to forgive the GOP for not doing their job (because why even try if the big, evil, secular Islamo-fascist president will just use his ninja assassins on all who oppose him?).
Also, civics lesson: when something has MASSIVE support in the legislature, it can override a president's veto.
@pp...here we go
Let me get this straight -- a Republican suggestion 20+ yrs ago (I think then cookie-making First Lady Hillary was the author of the alternative back then -- but that's my conjecture) is your basis for saying the ACA was a compromise?
Are you still getting your news from the third stall on the right, or what the squirrels tell you?
It was a compromise with a
It was a compromise with a group of people unwilling to compromise. As I recall, when asked for their input, the GOP came up with a 3 page healthcare overhaul "plan" that included no specifics and no numbers.
Compromise requires the involvement of two parties. One party was willing to participate. Obama went ahead and threw out single-payer as an option from the get-go, in a naive attempt to placate Republicans.
In any case, though, what I said stands. If you don't like it, come up with a better idea and have it pass congress. Don't blame others when your plan doesn't get considered, especially when you don't even have one. Face it, your political party is completely reactionary. It has no ideas of its own.
(also, nice rhetorical play in marginalizing Hillary Clinton--I think wife-on-deathbed-divorcing-while-cheating-on-her Newt Gingrich could learn a thing or two from you)
@pp -- you should stop
because my next question is: How did Romney vote on this compromise? I recall there was one GOP rep from Louisiana that voted for it, but I didn't catch Former Governor Romney's vote.
"It was a compromise with a group of people unwilling to compromise" Or maybe you're saying it was a compromise before the GOP became uncompromising?
Persnickety, I dont hold office, cant draft a bill. By the looks of my approval ratings with this crowd, I couldn't get elected Dog Catcher. I'm happy to be a part of it all.
Who cares about Romney?
Who cares about Romney? Please, sir or madam, your red herrings are not particularly compelling.
@pp -- again, please stop.
Your words: "the ACA is essentially what Mitt Romney passed in Massachusetts, and is essentially what Republicans suggested in the 90's as an alternative to single payer. SOUNDS LIKE A COMPROMISE TO ME. (note: when I speak in capitals, I'm mocking you by stating something obvious you refused/neglected to understand, I'm not yelling at you all angry-like)"
sounded to me like you were citing Former Gov Romney's stance as relevant to your argument about compromising. Call me crazy; I've been called worse. But I'm here to help.
I like the expression
"I'm here to help"
Glad to know that
@Grendel: yes, it is what
@Grendel: yes, it is what Romney passed. In the absence of any real negotiations, what could Democrats do but look at past and present examples of GOP healthcare positions?
Admit it--no matter what Obama would have done, you'd be criticizing him. If he decided to join the GOP and adopt political positions on par with Paul Ryan's, you'd call him a sleeper agent socialist or you'd redefine, yet again, the word "liberal" to reflect his wingnut views (and subsequently move even farther into loonitarian land yourself to keep to his right).
I'm a little afraid of the
I'm a little afraid of the far right because they're so vocal with extreme views.
PP, you dont have to play the game they do, you come across as the exact opposite on the other side (no better).
Rise above :)
@pp
You are a hoot! You think I'm a Republican and a Roman Catholic just because I dont like seeing our Constitution ignored and the feds walking all over religious conviction. You assume too much for the sake of brow-beating a dissenting opinion.
You use words like "hate" and "fascist" so fast and loosely that I can only imagine the tirades you subject your cats to at home.
How about we give it a rest. This isn't getting anywhere and you're only digging a deeper hole.
Grendel
I agree -- give it rest and spend some time just thinking.
this is another bunch of stupid
All the whining about healthcare access in the world won't magically create a pot of gold to pay for it.
People should have to pay for at least part of their healthcare and 100% of it when they create the diseases.
If you have the $$$ to smoke; you have the $$$ to pay to try to reverse your willfully self-inflicted damages.
If you have the cash to gorge yourself on garbage and pay for all kinds of workers and vehicles so you don't have to do anything that resembles taking care of yourself or exercising; you have the cash to pay for your own bariatric surgery, hip and knee replacements, diabetes and hypertension meds, etc.
It really is that simple. If Americans can't be trusted to responsibly use the handouts they receive; the handouts should be eliminated or extremely heavily restricted so people can't use their own poor judgement to self-destruct on taxpayer money twice over.
I can't fathom why anyone would believe another human being should pay for their or their kid's basic necessities - like food and healthcare. That is the parent's responsibility. If they fail; they can do court ordered work like picking up garbage on the side of the road or cleaning up at an animal shelter to earn the taxpayer funded handouts they thrive on now.
That would end the grubbing of WIC, food stamps, public assistance, HEAP, medicaid and denali kid care real quick...and people would live healthier.
@Do Right
That's the point.
It's costing us TWO pots of gold to pay for it now. And that cost is rising out of sight.
A whole lotta other countries have set up universal systems that cover everyone and do it for about half of what we're paying.
So what's a 'whole bunch of stupid' is us continuing to do the same thing we have been doing to pay for healthcare when there are dozens and dozens of examples of better ways to do it.
Regarding your whole personal responsibility rant...OK.
Let's say you get diagnosed with colon cancer (seriously, I hope not), do you realize that the largest contributor to colon cancer is the eating of red meat? Very clear correlation. So unless you're a vegetarian, you're probably largely at fault for your ailment. Pay up. It's gonna be expensive.