With the Supreme Court deciding in favor of the Obama administration on the question of whether federal health insurance subsidies are legal, the rule of law – and the English language – took a real beating. As President Barack Obama takes a victory lap, he needs to realize that this is not the end of the fight.
It is true that the court's decision renders the federal Obamacare subsidies legal. But that does not mean an end to the conversation about health care in America, and it certainly does not make Obamacare a permanent institution. The simple reason for this is that there is no way the president's health care law can survive in the long run. It is structurally unsound, and the court's ruling will merely delay its inevitable collapse.
Across the country, the insurance exchanges established under the Affordable Care Act are falling apart. They are running deficits in the millions that are simply unsustainable. Even with the subsidies in place, the cost of premiums has been rising sharply, and deductibles are so high that many on the bottom rungs of the income ladder, the very people the law was meant to help, are actually being hurt by it.
Enrollment numbers are also far below expectations, meaning that only the people who need medical care the most are signing up for Obamacare, while many healthier Americans don't bother. The only way insurance can work is if healthy people sign up as well. If they don't start signing up en masse, premiums will keep rising in order to keep insurance companies solvent. We're rapidly heading for a situation in which people will have to choose between going bankrupt to buy mandated insurance, or going bankrupt to pay the penalty for not buying it.
What all this means is that the health insurance market is in deep trouble. In Chief Justice John Roberts' majority opinion in King v. Burwell, he wrote that "Congress passed the Affordable Care Act to improve insurance markets, not to destroy them." That may have been Congress' intention, but the fact is that markets are in deep, deep trouble, and this decision does nothing to change that.
[SEE: Congress Cartoons]
The 2016 election will be crucial in determining what will happen when Obamacare meets its inevitable end. If Hillary Clinton becomes the next president and Republicans lose their majority in the Senate, the most likely response will be all out nationalization of health care markets, and America will follow the misguided path of social democracies in Western Europe. If Republicans carry the day, there will be an opportunity to enact free market health care solutions that empower patients and doctors, and make health care more affordable for all Americans. Let's hope they don't waste this chance to save our health care system.
The court's decision is a disappointment to those of us who believe that words mean what they mean and that the IRS shouldn't be allowed to rewrite laws to suit its agenda, but that's no reason why we should hasten to wave a white flag. Obamacare will stand for now, but sooner or later it will fall, and reformers had better be ready. What happens next will depend on which side has better prepared for the collapse. The battle going forward will be over laying the political and popular groundwork for repairing the health care system when Obamacare finally tears itself apart.
http://www.usnews.com/debate-club/are-the-obamacare-wars-over/the-court-only-delayed-obamacares-collapse
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