Full speed ahead for Obamacare
President Obama's big Supreme Court victory has Democrats smiling from coast to coast.
Thursday's landmark ruling upholding the constitutionality of "Obamacare" by the U.S. Supreme Court has sparked a predictable and probably unending debate about the court's opinion among legal scholars.
But what matters is this simple fact of life: the U.S. Supreme Court was last in the long line of courts that heard the issue.
So absent a political upheaval in the November election, Obamacare stands with full implementation at a cost of many billions of dollars annually to follow.
The ruling was unusual, featuring a majority of one — Chief Justice John Roberts — on the nine-member court.
Conservative dissenters Anthony Kennedy, Antonin Scalia, Samuel Alito and Clarence Thomas found the Obamacare mandate that directs the uninsured to pay escalating fines if they do not purchase health insurance to be in violation of the U.S. Constitution's commerce clause. They argued the Constitution does not allow Congress to mandate economic activity in order to regulate it.
Court liberals Ruth Ginsburg, Steven Breyer, Elana Kagan and Sonia Sotomayor dismiss that argument out of hand, finding the commerce clause imposes no restraints on congressional authority.
Joining the liberals, Roberts supported the conservatives' position by finding the mandate violates the commerce clause but upholding the constitutionality of Obamacare by ruling the fine for not complying with the insurance mandate is really a tax well within congressional authority.
Given President Obama's repeated and bold assertions that the mandate was not a tax, Obama found himself in an odd position. He was grinning from ear to ear as he claimed victory, even though the court's ruling repudiated the legal position he embraced during the congressional debate.
Nonetheless, he won, while opponents of the legislation suffered a devastating, but not total, defeat. The ruling bars the federal government from forcing a dramatic expansion of the Medicaid rolls on the states, although that flexibility will make no difference in Illinois.
Gov. Pat Quinn, complaining just a few weeks ago that Medicaid costs are bankrupting the state, immediately announced that he will move quickly to expand Medicaid rolls by as many as 500,000 more people. Obamacare will pay most of the expansion costs until 2020, but state Comptroller Judy Baar Topinka still estimates that the expansion will cost Illinois taxpayers $2.6 billion — money Illinois does not have — over the next six years.
Quinn scoffed that Topinka's numbers are way too high, and he may be right. But there has been one consistency over the many decades of experience with social welfare legislation — cost estimates have always been way too low.
Availability also will be an issue for new Medicaid enrollees. There are not enough medical providers to handle the current patient load, let alone thousands of new patients. Ultimately, Medicaid recipients may find they have no provider willing to accept the state's limited and late payments.
Also not discussed in the court's opinion but a major factor in the life of the nation is the huge cost of Obamacare, the many new taxes it imposes beyond the individual mandate and the effect the ruling will have on a staggering economy that threatens to fall back into recession.
Clearly, trillion-dollar federal deficits will continue for the foreseeable future, with the debt load eating up bigger and bigger pieces of the federal budget. In Illinois, which is effectively bankrupt, increased spending on Medicaid will place greater pressure on other areas of the budget, including public pensions, education and law enforcement.
With federal and state governments staggering under debt and deficits, it's all the more important to get the economy humming again. People need jobs, government needs taxpayers, and we can't have one without the other.
The new taxes imposed by Obamacare, the health insurance cost uncertainties facing private sector business owners and entrepreneurs and the overall weak economy constitute a major disincentive for people to hire, to invest and to expand. They create a major incentive not to do anything until the economic fog lifts.
This, however, is what the people's representatives in Congress chose. In the course of writing his opinion, Roberts wrote that it's not the court's job to protect the public from the consequences of its electoral choices.
There's an election in November. Obamacare supporters will have their man at the head of the Democratic Party ticket. Presumptive Republican nominee Mitt Romney has promised to repeal and replace Obamacare. The choice could not be more clear.