Thursday, May 17, 2012

Scariest words in politics: If the court... -- May 17, 2012 column


For a politician, nothing is worse than yanking away someone’s benefits in an election year.

It’s always easier to give than to take away, even if the budget is strained or the goodies are part of a health care reform law many Americans love to hate. It’s fine to hate a law as long as it’s in place, however tenuously.

With the Supreme Court expected to rule on the Affordable Care Act, known as Obamacare, by the end of June, the scariest word in politics is If.

If the court overturns the law, what then?

The court has many options, and the consequences are uncertain. It could blow up the entire law, although most analysts think not. It could scrap the “individual mandate,” which requires almost all Americans to have medical insurance by 2014 or pay a financial penalty, and leave the rest of the law intact. It could strike the mandate and other provisions as well. It could let the law stand, as is.

Americans by substantial margins say they favor repeal, mostly because of the hated mandate. No matter that only 7 percent of Americans actually would be required to buy insurance and 93 percent would be covered through employer-sponsored plans and other exemptions, according to a study the Urban Institute released in March. The idea that Congress can compel the purchase goes against some grains.

At the same time, people love allowing children under 26 to stay on their parents’ insurance plans, closing the “donut hole” that requires some seniors on Medicare to pay more for their medications, and ensuring that people with pre-existing medical conditions get coverage.

The White House’s official position is that the court will uphold the law, so it’s making no contingency plans. Congressional Republicans have managed so far to play to both sides.

The Republican majority in the House has voted 29 times to repeal the law, knowing that the votes are all theater because the Senate would never go along. The Republicans insist they intend to “replace” the law but never explain which provisions they’ll keep beyond the most popular, including children under 26.

How the court’s ruling may affect health care is anybody’s guess, but the politics are clear. Come November, no one running for office wants to explain to the parents of a jobless college grad that their son is going to lose his health insurance.

No politician wants to tell Grandma she has to dig a little deeper for her meds or that her grandchild with a pre-existing condition may lose coverage because insurance companies can again deny coverage.

No one wants to tell some 32 million people near the poverty line who were in line for coverage under Medicaid that they won’t be covered after all.

The court could leave all this up to Congress to sort out. And that would put House Speaker John Boehner in a ticklish spot, trying to win House seats while appeasing the Tea Party set.

News reports say Boehner is quietly making plans for the Republicans’ next step, post-Supreme Court. He told the House Republican Conference behind closed doors Wednesday, “When the court rules, we’ll be ready,” Politico reported, relying on tidbits gleaned from those in attendance.

“If all or part of the law is struck down, we are not going to repeat the Democrats’ mistakes,” Boehner told his party, according to Politico. “We have better ideas on health care – lots of them. We have solutions, of course, for patients with pre-existing conditions and other challenges.”

Really? Let us see the solutions.

Ah, but that was in private. A day later, for public consumption on his House speaker blog, Boehner declared, “Anything Short of Full ObamaCare Repeal is Unacceptable.”

Once the court rules, Boehner said, the House will “work on step-by-step, common-sense legislation that will help lower health care costs for families and small businesses, and protect American jobs.”

It was a familiar refrain. He didn’t say what any of those steps might be.

It’s spring, and politicians tremble for what may come this summer. If the court overturns…

© 2012 Marsha Mercer. All rights reserved.


1 comment:

  1. Obamacare is a very complicated issue, but Ms. Mercer does an excellent job updating our knowledge of the subject. What if ..... indeed. Nice work Ms. Mercer. Keep on keeping on.