Big news today, as many of you have no doubt heard. In a 5-4 ruling, the Supreme Court upheld the constitutionality of the individual mandate. I would have, amusingly enough, had a lot more to say today about the Supreme Court's decision had the ruling gone the other way, but it didn't, so I don't. All I can really say is that I'm happy it went the way it did. I know whoever is on the losing end of a court ruling will rail about unelected judges legislating from the bench, but had the mandate been struck down, it would have been pretty blatantly political. The way I see it is that if 19 out of 21 top constitutional scholars think that the mandate is constitutional, then there's a pretty good chance that there's something to what they say. But this blog is about economics and politics, not law.
I'm not going to get into another argument about why the mandate is necessary, or why the Republican alternatives put forth so far won't work or are irrelevant. I've done that before at length. I guess what I'd like to do is to take a look at what Republicans are saying about the ruling. Here's John Boehner:
"Today’s ruling underscores the urgency of repealing this harmful law in its entirety. What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans’ access to the care they need, from the doctor they choose, at a lower cost."On the Senate side, here's Mitch McConnell:
"Today’s decision makes one thing clear: Congress must act to repeal this misguided law. Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire. Today’s decision does nothing to diminish the fact that Obamacare’s mandates, tax hikes, and Medicare cuts should be repealed and replaced with common sense reforms that lower costs and that the American people actually want."In typical form, Rand Paul says something silly:
“Just because a couple people on the Supreme Court declare something to be ‘constitutional’ does not make it so. The whole thing remains unconstitutional. While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right.”And just because an Ophthalmologist/politician from Kentucky says something is unconstitutional, does not make it the case, either. But I digress. In any case, these reactions are about what I expected--generic condemnations of a law that contains many provisions Republicans support, coupled with equally generic statements about what the American people want.
Let's start with the fact that they all contend that the law is a government takeover of health care that will limit choices for consumers. The law tells states to set up their own insurance exchanges where private, for-profit insurance companies compete for your business in an online marketplace where consumers shop for the insurance plan they want. Nothing about this screams "limited choice" or "government takeover" to me. Does the law put forth regulations on the insurance industry? Yes, of course it does. How else are you supposed to enact health care reform? But it by no means looks like a government takeover of health care, a la Britain's health care system.
As for lower costs, I think there's a fair amount of research on this, which argues that premiums will be lower overall because of competition in the exchanges coupled with the fact that healthier people will be brought into the risk pool via the individual mandate. The idea that this law will somehow increase insurance costs for people seems patently false based on the credible research available to us.
As for businesses, as I've said time and time again, their main concern right now is demand. Government regulation complaints are fairly close to what they've been for the past decade. Moreover, polling suggests that the hype surrounding small business opposition to the law has been way overblown, and that a majority of small business owners polled support the law. Makes you wonder, doesn't it?
I think the Supreme Court made the right decision today (well of course I would, wouldn't I?). I think the Affordable Care Act, while far from perfect, is probably America's best shot at achieving a system of universal health care. Republicans, for all of their bluster and outrage towards the law, cannot deny that they once supported many of the provisions found within it. They can talk all they want about how they will "repeal and replace" the law, but so far their proposals leave a lot to be desired.
The funny thing is that Democrats traditionally supported a single-payer system of health insurance, basically Medicare for all, with Republicans favoring something closer to Mitt Romney's health care plan in Massachusetts. Since Obama took a more conservative approach to health care reform in order to try to be bipartisan, Republicans have had their ideas co-opted and have put themselves in the intractable position of vehemently opposing ideas they once lauded. Let's see if they can come up with a credible alternative.
So far I'm not impressed.
Update: This post's popularity was so high that it put me over the 5,000 view mark! Thank you all for your readership!