The speculation on what the Supreme Court will decide, and its potential impact has come up in discussions with my clients far more this month as in the past since the decision is just days away. The main question is whether the health law’s requirement to carry insurance or pay a fee, known as the individual mandate, is constitutional. I’ve addressed it in meetings as my opinion only, and thought you’d find it interesting:
There are two answers
If the court keeps it in place, attention would shift to preparing for millions more Americans to get coverage starting January 1, 2014 and for businesses to pay new taxes and significant penalties for non-compliance. If the court strikes down all of the law, consumer-friendly benefits such as Medicare drug rebates likely would disappear along with the requirement that some people pay a fee for going uninsured. The individual mandate comes with a fine ranging from $695 for poor Americans to $12,500 for upper income families who choose to remain uninsured. I predict the vote by the Supreme Court will be along party lines and will end up at 5-4; sadly partisan for a supposed non-partisan judiciary. The ramifications in runaway costs that have been backloaded into the legislation are especially onerous beginning in January 2014. While a few features have been implemented and are reasonable, such as the extension of age coverage for dependents to age 26 and the pre-existing condition coverage, the overwelming concern is the costs that have been grossly understated, the impending flood of uninsured and explosion in the Medicaid rolls throughout the country, and the shortage of physicians, leaving the taxpayers like us and our dependents with many years of debt to be passed along to future generations.
If all or part is struck down – and the looming question is whether the Supreme Court can extricate parts such as the mandate or whether they must invalidate the entire law, there’s just no clear path to follow, and no magic potion. Surely it would be bad news for the Democrats, especially those running for reelection from all levels up to and especially including the White House, because we all know this health law debate has had the moniker of “Obamacare.” It’s already been declared very unpopular in national polls – not even close to 50% in favor of the law from the day it was passed. A defeat of the healthcare law may in fact serve to energize the Democrats who will blame the Republicans on the Supreme Court, and I expect the White House to be the lead voice of discontent because they have already primed that pump when President Obama suggest that the Supreme Court “Do the right thing and uphold it” a few months ago. Republicans should seek consensus in rebuilding a new healthcare law. That would be quite a switch, given that the existing law now debated was hardly shred with anyone outside of Congress and the White House until it was passed. So many holes and hidden costs…….It will be challenge to pick and choose the popular aspects of the current law like the extended coverage, pre-ex, and drug benefits for seniors. Having reasonably-priced health insurance coverage going forward without the actuarial advantage of getting most everyone to pay into the system to spread the risks and defusing the mindset of the young and healthy to either pick and choose or buy coverage only when needed is a real conundrum. The irony is that if the law is struck down in part or it totality, the Democrats will have this huge dark cloud lifted. None of the posturing addresses one of many concerns that the overall cost of healthcare continues to rise at an alarming rate. A recent report indicated that a family of four will spend about $20,000 in medical costs compared to $12,000 in 2005.
In summary, there’s risk for both parties, a close vote is looming and both Democrats and Republicans have spent months tailoring their spin, and a Supreme Court that made up its mind months ago and has taken its time to prepare its explanation is about to present a landmark opinion.