OK, so the ACA is now Constitutional, despite the insistence of Rand Paul that it is not because, well, he doesn’t like it;
“Just because a couple people on the Supreme Court declare something to be ‘constitutional’ does not make it so.
The whole thing remains unconstitutional. While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right,” Sen. Paul said.
“Obamacare is wrong for Americans. It will destroy our health care system. This now means we fight every hour, every day until November to elect a new President and a new Senate to repeal Obamacare,” he continued.
Oh Christ, let’s not spend too much time on this bubblehead, but it is a touch disconcerting to see an actual US Senator display that level of stupidity about the role of the Supreme Court.
Rand, brother —”Just a couple of people” decided, in exactly the same way, that money and speech are synonymous and that corporations are people so far as the Bill of Rights is concerned. We feel your pain. Deal with it, you little shit.
Anyway, in the end, the only person I know of on the whole internet to predict both the outcome and the Constitutional principle upon which that outcome would be based, is our intrepid Bluthner.
I thought that the argument for the ACA which appealed to the Commerce Clause would be struck down, as it in fact was, for reasons that have been hashed over so much there’s surely no need to go over it all again. I simply did not understand the “tax and spend” argument which Bluthner advanced, and ultimately Chief Bottlewasher Roberts applied, to uphold the law.
So there it is. Basically, as I understand it, the entire framework of the ACA is now approved with the single exception that, in the event an individual State decides not to expand Medicare as dictated by the ACA, that State may not be “punished” by having Medicare funding for existing programs withheld. This essentially renders the Medicaid expansion mechanism optional on the part of each State, since the “penalty” for noncompliance is removed.
This last is odd, and we’ll be hearing more about it in the future without a doubt. I remember back when the Feds decided years ago, during an oil “shortage”, to mandate a 55 MPH speed limit from coast to coast, even on State Highways. This was accomplished by the threat of withholding Federal highway funding for noncompliance. Presumably now, with this new “anti-coercion” principle enshrined in the ACA decision, such schemes would be disallowed, and the effect that this principle may have on all sorts of programs which involve State/Federal participation could be profound. Certainly there’s ammunition there for a whole new round of legal challenges to programs for which there is strong ideological opposition.
Anyway, we are where we are, and this is now what we’ve got in terms of trying to deal with the US health care crisis. And it is a crisis, despite what various cheerleaders for market wisdom have to say. There are going to be no further substantive changes for a good long time, so the task is to do the best we can with what we’ve got.
If I was in charge of the White House PR campaign now, I would advocate a Full Court Press to actually explain what the ACA does and does not do. If any single thing is clear from the polls it’s that people don’t really have correct ideas about what the ACA actually is. This is no accident of course—there has been a very expensive campaign from the right to produce exactly that result, and in their usual bungling fashion the democrats have failed miserably to counter it.
Given that Willard is running (so he says today, anyway) on a policy of repealing ACA, more oceans money will now be sluiced into muddying the waters, and it would be smart to get out in front of that, and fast. I remain convinced that most of the “opposition” to the ACA is rooted not in a dislike for the real provisions so much as a manufactured ideological boogeyman. Time to fix that.
There are in fact enough positive provisions in this Act to make it perfectly palatable to most Americans if its proponents can break through the noise. I wish I could express confidence that they will, but that’s not the kind of thing they’re very good at, judging by earlier form.