Local View: Survival of health-care reform still uncertain

Before the Supreme Court ruling on the Affordable Care Act, or ACA, or Obamacare, I hypothesized that any decision would energize both ideological bases. If the law were struck down, liberals could run against the Supreme Court and conservatives would argue that President Obama’s signature piece of legislation was unconstitutional. On the other hand, since the law has been upheld, liberals can rejoice while the conservative base will be even more motivated to repeal the law.

The decision is a mixed bag for Democrats. They are jubilant, but the argument for constitutional legitimacy put forward by Solicitor General Donald Verrilli has been nullified. Under the original bill, those who did not comply with the individual mandate would pay a penalty. The solicitor general argued that this was valid under the interstate commerce clause. But Chief Justice John Roberts’ majority opinion instead upheld the individual mandate under congressional authority to tax.

In other words, the individual mandate survives as a tax.

This is especially problematic for Democrats because the president and his allies in Congress stated specifically that the bill did not amount to a tax increase. Arguing that it was a tax increase almost certainly would have doomed its passage.

While supporters were celebrating the ruling, Sen. Marco Rubio, R-Fla., was saying: “I think it’s telling that a victory for the Obama administration means a middle class tax increase.”

Additionally, the court ruled that the federal government could not withhold Medicaid funding to states that choose to not expand Medicaid eligibility. This creates uncertainty as to how well the ACA will help those for whom the law was arguably most intended, namely those in the lower middle class who do not have health insurance and who also do not qualify for Medicaid.

The Supreme Court did not rule on the wisdom of the ACA, either. Polls show that a plurality of Americans does not favor it. An even larger number oppose the individual mandate. However, some aspects are popular, such as making it unlawful for insurance companies to deny coverage to those with pre-existing conditions.

The court vindicated President Obama on his signature legislation. However, if polls and the results of the 2010 midterm elections are any indication, the decision might not fare too well for candidate Obama.

Despite some redeeming qualities, the ACA is not well-thought-out. While our system is imperfect, the ACA goes too far by attempting to fix parts of the system that aren’t broken. It hurts the economy by raising taxes on businesses and families, and it faces serious questions as to how it will be implemented and paid for. Widespread skepticism remains as to whether the ACA will actually control rising costs as the administration promised. It also fails to ensure that every citizen will be covered.

As an alternative, health care could still be addressed through the tax code by giving tax credits to individuals and families to purchase health insurance that suits their needs. Granted, the ACA does do something similar at certain income levels, but building on this idea instead of expanding Medicaid would be preferable. A deduction or credit like this could make insurance that is not tied to employment more affordable and would give people greater flexibility in career choice.

Also, meaningful tort reform and allowing people to purchase health insurance policies across state lines would empower individuals, encourage competition and reduce costs.

America has arguably the finest health care available in the world. We should work to improve access to quality care and fix flaws instead of enlarging government bureaucracy and turning insurance companies into de facto utilities.

Dave Zbaracki of Duluth is a writer and a libertarian-conservative activist with degrees in political science and history from the University of Minnesota Duluth.

Tags: local view, opinion, health, politics, editorials