What If. . .
the US Supreme court rules. . .
Washington is rife with rumors and the Washington Post is writing about them (http://www.washingtonpost.com/politics/white-house-lawmakers-prepare-for...). Excerpts:
In this city of rumors and leaks, it has been an excruciating lead-up to the Supreme Court ruling on President Obama’s health-care law. The decision is just days away, but virtually no one knows precisely when it will come or what it will say.
Each day brings a new wave of speculation via Twitter and Washington gossip channels. And behind the scenes, Republicans and Democrats are strategizing about what to do in the moments and days after the most consequential high court decision in a generation — a ruling that will reverberate politically and in the lives of everyday Americans.
At issue is Obama’s signature legislative achievement, an expansive revision of the nation’s health-care system that the court could uphold, throw out or something in between — allowing much of the law to stand, for example, but striking down the requirement that individuals buy insurance.
White House allies already are offering their spin in the event that only the “individual mandate” is overturned. Their message: The rest of the law could still succeed.
“Is [the mandate] important? Yes,” said Ronald Pollack, head of Families USA, one of the key consumer groups that helped craft the measure. “Is it the most controversial provision in the Affordable Care Act? Most certainly. But is it the heart of health reform? No, not even close.”
The posturing hints not only at the enormous and largely unknown consequences of the decision, but also the sensitivity surrounding the 2010 law, which has emerged as a significant issue in the presidential campaign.
Although polls show that Americans are stubbornly divided over the measure, parts of it remain very popular and many Democrats and Republicans agree that something must be done to rein in ballooning health-care costs.
Top providers, such as UnitedHealthcare, Humana and Aetna, have rushed in recent days to reassure their customers that if the entire law is overturned, the companies will continue to offer preventive services without co-pays and allow adult children to remain on their parents’ plans.
But the most prominent insurance trade group, America’s Health Insurance Plans, has been making the case that if only the individual mandate is invalidated and the rest of the law is left intact, premiums will rise and the insurance market for individuals will implode. The organization has run advertisements in online newsletters and on sites targeted toward health policy insiders.
It seems to me that the most likely outcome is a repeal of the individual mandate. And then, as noted by the paragraph immediately above, the health insurance industry will tank the rest of the law as fast as they can. The political power of the US health insurance industry, which created the individual mandate in the first place, far outsizes the puny contribution to health system function that the health insurance business model makes. Government needs to stop propping up this useless industry. Let it fall into the waste bin of history so we can get going on finding a far better alternative for health care financing.
Dr. Joe Jarvis