Implications of the Affordable Care Act

Posted at: 07/06/2012 6:03 AM
By: Dr. Timothy Kneeland | WHEC.com

Despite initial anger at the Supreme Court decision regarding President Obama’s Affordable Care Act, conservatives have managed to turn lemons into lemonade in the last week and raised millions of dollars from those who hope a new administration will repeal aspects of the law they disfavor.   Despite trepidation among liberals that the Court was going to strike down the Affordable Care Act, last week President Obama and his White House staffers were able to take a victory lap to celebrate their vindication by the Court and to bask in the recognition that the President had the most significant advance in government health insurance since the Great Society generated Medicaid and Medicare. 

That was the past – what does the future hold?  Certainly, more law suits over the mandate once it takes effect.   Ruled a tax the application of this new taxing power will no doubt lead to challenges over enabling legislation and collection.   At the state level governors will be busy determining how they might embrace or reject the increases in Medicaid the legislation sought, and the President and his party in Congress may look for other means to cajole or force the states into accepting the increase.  This too could lead to further action in the courts. Other provisions will also likely lead to challenges so that the Affordable Care Act may have been saved by the “switch in time” but in the end may look quite different following future litigation.

In the long run, there are many aspects of the law that are favored by a majority and these will be retained (coverage of pre-existing conditions and retaining young adults to age 26 on parent’s insurance).   Frankly, the idea of complete repeal may be filling Republican coffers but it is highly unlikely that the Republicans will have anytime in the near future a significant enough majority to stifle a filibuster by Democratic Senators that would keep it from coming to a vote on the Senate floor.   The individual mandate is the first, but not the last step, in covering everyone and recognizing (or creating) health security as a human right.

My next blog will report on how the American Presidential election is being covered in the United Kingdom.    

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