I never seriously worried that the Roberts Court would invalidate the Affordable Care Act and I was mildly surprised that they even went so far as to make Medicaid expansion optional. In retrospect, I guess Chief Justice Roberts was feeling some very intense pressure and tried to come up with a compromise that wound up satisfying no one. Still, I remain sanguine about the newest challenge to ObamaCare for all the reasons that Brian Beutler points out. Those who have bet on the Republican Party behaving in the worst way possible have been consistently vindicated. But those who have made the same bet on John Roberts have not.
The tendency is to act very, very badly, but not in the worst way possible. So, if this trend holds true, the conservatives will get something out of their challenge but not what they’re seeking. They may even get the worst of all possible worlds, which would be the responsibility to fix the statute without any way of overturning it. Or, more likely, the Court will rewrite the statute in a way that makes the law work with less ambiguity, thereby taking away an inane Republican talking point.
What Roberts is unlikely to do is to break the exchanges and infuriate hospitals and insurers all over the country.
Thanks, Boo.
With all the hysteria I’ve seen published on this, I was starting to think I was misunderestimating the malign nature of this court.
He’s a bad guy, but I guess he’s no Scalia.
Invalidating the subsidies would be seen by everyone as a political action, something Roberts is very sensitive to. Still, I do worry about it some, and if 4 justices vote with the wackos, it shows how close our courts are to being just another political branch.
That is what I don’t understand. Why would Republicans want to stop the insurance companies’ money train? Haven’t they made their quarterly contributions to the party?
Well, Republicans signed themselves over to the crazies, because the regular conservatives don’t provide enough votes, and you can’t expect them to be rational. Roberts, however, doesn’t work for the Republican party, I figure; he works directly for the FIRE industries, whose short-term and long-term interests are built into the ACA. They didn’t lose anything in the wreckage of the Medicaid expansion, but losing the subsidized policy holders in the federal exchange would be a huge loss.
Incidentally that’s why I like the ACA, faulty as it is, and what I’d really like to see is a system like France’s or Germany’s that buys in the insurance industry rather than a true single-payer system like Britain’s, because it’s less vulnerable to ideological crazies like Thatcher or Stephen Harper, who is much more dangerous to Canada than Thatcher was to UK.
Pardon me, but Canada has single-payer. England has the NHS which is as close to socialized medicine as western, developed countries have come. All the others have some sort of mix but profits don’t, or only very minimally, figure into the equation.
Canada’s system is a twenty-five to thirty years news than the UK’s NHS. And is it controls only one piece of the puzzle, it’s had a higher inflation rate in health care spending than the UK.
The OECD has a good comparative chart. (Not embedding it because it looked as if it messed up the comment margins.)
Canada has it for now – note the phrase “Stephen Harper” in the comment
Thanks Errol.
Especially since invalidating it hits republican states the hardest. California has a state exchange – so does Minnesota, Washington, New York, etc. Only KY and a few other GOP states would be safe. The “how to screw dems” equation here is much more complex than the mainstream media is portraying it.
Any pain the GOP can cause their base is proof they were right about the law in the first place, even if their compadres are the authors of the pain.
Absolutely. This locks in their base.
Who among us saw that the SCOTUS would take Bush v. Gore and end up ruling that counting the ballots in FL would deprive GWB of his equal protection?
Who among us saw that the legally narrow CU lawsuit would end up overturning most campaign finance laws?
No way to predict what this court will do with this case. Could go anywhere from the subsidies are okay as implemented to declaring large parts of the PPACA are unconstitutional.
Learned long ago that my odds at a craps table are better than predicting outcomes in civil suits. (I not infrequently had to remind small/med sized businesses not to count on a favorable outcome of a lawsuit to save their business.)
That’s because the crap tables, even at mob joints, are more honest than our courts.
Has Tom Donohue, and the national Chamber of Commerce, weighed in yet? That’s who controls, basically, Roberts’s vote. I’m not as sanguine as Boo. I believe Roberts will still try to f-ck with the ACA, just like last time.
I think he’d love to fuck the ACA and all those in need of it, but he doesn’t want to screw his rich corporate pals and, to a lesser extent, he doesn’t care to be remembered as the hack that he is.
… he doesn’t care to be remembered as the hack that he is.
Too late for that. He’s already remembered as a hack. Citizens United, among others, already cemented that legacy.
I am still trying to figure out if I should care about this law at all. Why should we have an enforced insurance law? Give everyone health insurance and increase taxes progressively to account for it. This looks like more grift to take money away through a regressive tax, looking like insurance and profits. So it is just possible the Court will cut us a break, but don’t count on it. Roberts was right. This thing is about more taxes.
I was barely in favor of single-payer. Because even that wouldn’t correct the institutionalized poor allocations of health care resources and would increase aggregate US health care costs as a percentage of GDP which was already at an unsustainable level. By the time single-payer advocates finally heard that it was a pipe-dream, they focused on anything to get more health insurance for more people. Totally overlooking that there were other ways to “skin the cat.” Less contentious than the PPACA, less expensive, more constructive, and easier to sell.
At a purely emotional level, I didn’t fully appreciate how much having employer paid health insurance and Medicare means to those that have it. It’s a marker of being “middle class,” what they worked hard for, and with flat/stagnant earnings over the past few decades it’s more integral to their self-worth than ever before. Even with that health insurance card, their experience isn’t so great. Their share of premiums keep rising as do the deductibles and coinsurance costs and paperwork nightmares. And it’s not as if they have quick and easy access to care either. How was that supply of health care providers going to be stretched to cover more people (with their new free or low cost insurance)? Would they have to wait even longer for appointments? Get ten minutes instead of fifteen minutes with a doctor? Given the US health care organization, their concerns were real and their resentments should have been easily predictable.
The ACA was an extremely important step in the right direction. There was never any chance the entire system would be healed all at once. Now we have to work hard to improve it. Unless Republican strategy changes big time between, first opportunity will be 2022, when if we work hard there could be three Democratic branches of government.
Only if one believes that private health insurance is the key to fixing the mess. Over sixty years on, the evidence for that position is slim to none.
But what would I know, I’m a socialist that merely recognizes that the dreadful UK NHS delivers care that based on outcomes is roughly similar to the US at less than half the cost (per capita and as a percentage of GDP) and includes everybody. (How millions are left out in the US? And we don’t even talk about the millions of immigrants.) Oh, and the UK’s senior population, as a percentage, is larger than that of the US.
We also spent more in public dollars before the PPACA than all but two countries with UHC. It’s like we buy a whole car but only get it by buying it a second time. For a country that whines about taxes, high health insurance costs, and low disposable income, we sure are fiscally stupid.
Or, you know, if it saved the life or health of someone you care about. Which, for me it did. Would I prefer single payer, or pure socialized medicine? You damn bet. Am I pleased that the half measures are saving people I care about? Yes, I am. And, no I’m not willing to sacrifice those people on the alter of making the perfect the enemy of the barely adequate. As someone who works in an industry that’s primarily made up of freelancers, the ACA is a really big deal.
The reason to care about this law is that it’s what we’ve got. Because the choice is not between the ACA and a perfect health care law, it’s between the ACA and total chaos. At this point there is zero prospect of any other kind of health care reform until at least 2017. As long as the ACA is in any way an improvement over the way things were, it’s worth keeping.
+1
Two family members are benefitting greatly from the law. I am a self employed person who doesn’t make much and depend on my wife’s insurance from her employer. The law gives us a sense of security should her job go away. These circumstances play out everywhere. To not be tied to a job just for the insurance gives workers freedom they did not have.
I feel the same way. Before the ACA, though I’m a well paid professional, being self employed I relied on the crappy policies available on the open market. If any of us had gotten sick, chances are good we’d find out our policy was Swiss cheese. Now my family has a truly solid policy. It’s not cheap. In fact, we pay a bit more than we did before. But it’s well worth it because the coverage is real.
The five conservative activists on the Court are judges in name only. Their rulings do not remotely respect precedent when the case involves a matter on the “conservative” agenda.
Wrecking the medicaid expansion was the price Roberts extracted from the Court’s four (so-called) lib’ruls in order not to vote to declare the whole thing unconstitutional, as the rest of his RATS did. There was no precedent supporting either tubing the ACA or ruining the medicaid provision.
As most here know, it take four justices to agree to take a case. We don’t know which four voted to hear this one. There was no reason to take it, as the lower appellate courts were working to unanimously support the law, and reject the legally bogus and simply absurd “conservative” argument. That four conservatives elected to take such a terrible argument seriously shows that this made-up case is totally up in the air.
It will all come down to what one justice (Roberts or Kennedy) thinks can be sold as “law” to the American boobs via our corrupt corporate press. I wouldn’t bet a Big Mac on the outcome.
I’m not at all up to speed on this, but certain statements just aren’t very convincing.
Says you, libtard.
Posits a tendency not in evidence.
So they’d just have to fix it your way right?
“It just might”? That’s reassuring.
They “will be made aware”? What wonderful mind-control power do the defendants possess?
As far as republicans are concerned, they just won the politics of the last government shutdown. Chaos is their friend. And they never bear consequences.
Put another way, this is all reality based analysis.
“Executive Discretion is at Stake”
This is a pretty big issue. There are hundreds, at least, of laws that have ambiguous provisions so the regulatory authorities have issued rulings interpreting them in the way they believe Congress intended. In the case of the ACA the IRS is the regulatory authority and has ruled that the credits can be used on policies purchased on either state or federal exchanges. If the Court rules that executive discretion does not apply and the law must be interpreted exactly as written despite ambiguities it would throw hundreds of other rulings and regulations into question. The result would be chaos. I would be pretty surprised if Roberts wants that to be part of his legacy.
I think if he moves against the law, it will be another “split the baby” decision which gives him plausibly deniability but also hurts or incapacitates the law. That’s where I would be directing my analysis: how can he thread the needle. Or, he won’t definitively move against the law, but he will make up so new principle which he can then bank for use later.
As much as we dislike the companies continuing to profit off insurance, it’s pretty clear that the business interests are protecting the ACA. If we had gone with a non-profit system, the companies would be fighting against it, and in today’s judicial system, it wouldn’t have had a prayer of surviving. I wonder if that was something Obama considered when he chose a course.
This has sort of been my feeling, too. Putting aside respect for “the law,” I think that the risk of institutional harm to the Supreme Court is too great for them to gut the ACA at this time. They may want to act politically, but they do not want to be thought of as a “political” branch of government. It would have been much easier to do this when the ACA was first challenged, when an adverse ruling would have had consequences for fewer millions of people.
That’s what I think, anyway. Of course, I’ve been wrong before.
Me too. Roberts already had a chance to gut the ACA, when the stakes were lower, and he passed.
And what price has the GOP paid for screwing up the ACA, besides Willard losing?
In presidential election years they’re paying the price for all of their backwards policies. In off years they’re not. Whose fault is that? I’d say it’s Democrats’ faults for not engaging in some serious economic populism. Republican lite does not excite the base and it doesn’t win converts.
What Roberts is unlikely to do is to break the exchanges and infuriate hospitals and insurers all over the country.
And how many of those “red” states prefer to let hospitals and stuff go bankrupt rather than take the Medicaid expansion?
I’m not convinced that anything is harmful to the Republicans politically at this point, so I disagree with the linked article on that score. I do agree that Roberts is concerned about his legacy. One thing I’ve not seen is any information on who besides Scalia is a textualist. Anyone here know?
If this case is so weak, why did the Court agree to hear it in the first place?