If the Supreme Court this week kills or mortally wounds the federal health care law, Gov. Scott and Florida Attorney General Pam Bondi will go into a victory dance. Here is what they will be celebrating:
Yet Gov. Scott and Ms. Bondi have joyfully led Florida’s fight against the Affordable Care Act, known to critics as “Obamacare.” One of the many ironies in this debate is that the law looks little like what Mr. Obama proposed as a candidate. He wanted to start on health care reform by covering children, and favored a public option.
However the court rules this week, news coverage will emphasize the politics. Spinners will work overtime. If the court upholds the law, President Obama and Democrats will proclaim it a great day for progress. If the court rules the other way, Republicans will proclaim it a great day for freedom from government tyranny.
In other words, the reaction will be partisan. Which brings us to another irony: the law is bipartisan.
The much-reviled individual mandate and the exchanges – government-supervised marketplaces in which health insurers compete for business from individuals and small business that don’t have the size to bargain? Those are Republicans ideas from the health care debate of two decades ago.
A conservative think tank devised the mandate, for the very sensible reason that a private insurer-based system needs everyone paying into it. One segment of the uninsured is the voluntarily uninsured, who claim the “freedom” to freeload on everyone else. Revenue from the mandate finances popular parts of the law: companies can’t deny coverage based on preexisting conditions, and parents can keep children on their policies until age 26.
As for expanding Medicaid to cover many of the involuntarily uninsured, that’s a Democratic idea. Medicaid was part of Lyndon Johnson’s Great Society program of the 1960s. Under the law, the federal government would provide 90 percent of the cost for Medicaid expansion.
Gov. Scott and Ms. Bondi call the Medicaid expansion an unfunded mandate, even though state participation in Medicaid is voluntary. The catch: If a state doesn’t participate, it doesn’t get the federal money, and must figure out how to finance health care for the poor. If Gov. Scott and Ms. Bondi lose on that point, will they want Florida to leave the Medicaid program?
However the court rules, what happens at the polls will matter less than what happens in doctors’ offices and hospitals. If the law stands, its major provisions don’t take effect until 2014, so whoever controls Washington will have to make the law work. If the law falls, whoever controls Washington will have to find an alternative.
Any alternative would have to be bipartisan. With luck, it would not be the bipartisanship that prevailed four months ago in Tallahassee.
Legislators – part-timers all — refused to end their cheap, taxpayer-subsidized health insurance. Republicans looked hypocritical because they call the federal law a “government takeover of health care.” Democrats looked hypocritical because they criticize unfairness in the health care system.
Our national health care system resembles Florida’s education system: more about tests than results. No celebrating until we find a cure.
Copyright 2012 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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