Like them big trucks trying to run the Biden bus off the road, California V. Texas is roaring down on us. Oral arguments start Nov. 10 in the Supreme Court’s hearing of whether or not the Affordable Care Act should be annihilated. From where I sit, the Republicans’ (read: federal government’s) support for this is pretty short-sighted.
Republicans have already painted themselves into a corner. They decided long ago (as documented in Robert Draper’s fine book, Do Not Ask What Good We Do: Inside the U.S. House of Representatives) that they could not afford to allow any legislative nor legacy success for President Obama, on the grounds that it would cost the Republican Party politically on a leviathan scale. The covert strategy on the Affordable Care Act, of course, was to throw glass shards into the thing when they could, so states would drag their feet on expanding Medicare, nnd Marco Rubio would nix high-risk corridor payments, and the federal government would cut back on reminding folks about open enrollment periods. Overtly, the mantra became “repeal and replace.”
The problem being that there are things Obamacare does that people like, one of the most striking of these being the provision that prevents insurance companies from screwing people with “pre-existing conditions” with their pants on. And so you have an impeached preznit who insists that they have already done away with Obamacare, but that, somehow, this protection would remain sacrosanct.
As observed previously by this wonk and others (a fellow Smirking Chimp contributor Miles Mogulescu does an A+ job of laying this out, here), there is quite literally no other way to maintain this promise (besides completely socializing medicine in the United States). The promise to repeal Obamacare but to continue protecting people with “pre-existing conditions” is the elbow-in-your-ear of public policy. It just can’t be done.
However, I do see a possible legislative way forward. It’s stupid. But hear me out.
So what if Congress went ahead and repealed the Affordable Care Act, then introduced a new bill called the “Schmaffordable Shmare Mact.” And instead of exchanges, this thing would have markets. And instead of subsidies, it would have oh, I dunno, call it “assistance for care.” Instead of a mandate, there would be a requirement. And so on. They could say, oh, no, this isn’t Obamacare. This is the Republican plan. It’s much, much better. They could keep their promise. They could save face. And Americans could keep their current coverages. Even Democrats could go for it because the results would be laudable.
Now, as I often remind people, I am not a lawyer. But as I understand it, California v. Texas entertains two clear paths whereby the Supreme Court could completely overturn the Affordable Care Act. That would render anything resembling it as completely vulnerable to constitutional challenge. Therefore, any future legislative efforts toward health care reform could be nothing resembling a mandate, a penalty, establishing state-wide exchanges, regulating shit insurance plans, etcetera.
That leaves only one reform option on the table, Action Jackson. And it rhymes with “Medicare For All.”
You know, Republicans, if you paint yourself far enough into that corner, there’s a little stool and a dunce cap waiting for you. Sit down and wear the hat. You’ve earned it.