What happens at the Supreme Court tomorrow is not being overhyped: it really is that important. But a lot of what you may hear tomorrow will be spin from both sides about the political meaning of the outcome — and even worse, reporting and commentary on that spin.And Ezra Klein reminds us what matters most regardless of what SCOTUS decides.
Ignore it. Dig deep here for the substance, because it really is more consequential than the shouting matches would lead you to believe.
The Court’s decision will matter, substantively, in two ways. First, depending on what the Court says, either millions of people will soon be able to get health insurance, or they won’t. Either insurance companies will essentially be transformed into regulated utilities — no lifetime limits, no recissions, a tough standard for the percentage of premiums that go to benefits — or they won’t. Either the new efforts to limit the costs of Medicare will continue to be implemented, or they won’t...
The second way this will matter substantively is about the Constitution. The Court may take a major step towards implementing an agenda of returning the Constitution — and the government in general — to how it was before the New Deal. Or it may re-affirm current Constitutional precedents. The results have incredibly far-reaching, and not fully predictable, consequences for everything that government currently does or that future Congresses and presidents might want to do.
That’s what’s at stake, and none of it will change based on who wins a short-term advantage in the spin wars. It just won’t.
I have no idea how the Supreme Court will rule. But I do have a prediction: given the ways they’re likely to rule, what will really matter for the Affordable Care Act is who the next president is.I agree with these two 100%. And so, unless what we hear this morning is a clear up or down on the whole law, I expect to take some time today on understanding exactly what the ruling is and will likely not be reacting immediately.
Broadly speaking, there are three ways the Supreme Court could go today. They could uphold the law. They could overturn the mandate, and perhaps some related regulations. Or they could overturn the whole law...
If the Supreme Court overturns the whole law, all bets are off. But most observers think that’s a fairly unlikely outcome.
If the Supreme Court overturns the mandate and some related regulations, then the law is missing its core regulations of the insurance markets. But it retains most everything else, from its subsidies to its cost controls to its delivery-system reforms. If Mitt Romney is then elected president, he’ll almost certainly repeal the remainder. But if Barack Obama is reelected president, the law survives. And, even without the mandate, it begins providing insurance to tens of millions of people in 2014, at which point there is no way Congress wil be able to remove it. So, eventually, Congress and the president will have to figure out some way to make the law work, either by replacing the mandate with other policies or by using waivers to kick the issue to the states.
If the Supreme Court upholds the law, then the law is unchanged. If Barack Obama is reelected, it goes into effect as written. But if Mitt Romney is elected, it is likely to be fully or substantially repealed before it goes into effect in 2014.
So, in the long-run, whether the law is fully upheld or the mandate is overturned matters considerably less than who the next president is.
Catch ya later.