Saturday, June 23, 2012

Obamacare and the end of Medicare

Since I am a bundle of pre-existing conditions, I feel like I have a great big stake in the success of Obamacare. What scares me is that the Supreme Court will declare Obamacare unconstitutional because it places too much of a burden on state governments trying to administer Medicaid. I fear that the Supreme Court will find large parts of both Obamacare and Medicare unconstitutional, as an overreach of enumerated powers and the Commerce Clause.

I find it hard to believe that the Supreme Court is going to strike down Obamacare simply on the basis of the individual mandate. I can't believe the Supreme Court would do all that work on striking down Obamacare only to leave the door open for true "single payer" socialized medicine the next time the Democrats controls Congress and the Presidency.

My wishful thinking is that the Supreme Court will rest on this politically unpopular, but Constitutionally defensible argument (from a conservative standpoint) --- Romneycare good -- Obamacare bad.

My biggest fear is that this Supreme Court will throw themselves in the political thicket in a major way. The Court would say that Obamacare and Medicare and Medicaid are basically unconstituional. They would then go on to say that the only way to wind down the government's involvement in health insurance is to adopt the Ryan Plan, which grandfathers in healthcare for the older, whiter population, and leaves the younger hispanic and asian populations to pay for something that they will never get. I feel so cynical writing all this. But I just wanted to be on the record that the possibility exists that the Supreme Court will issue another Dred Scott like decision on Monday, and blow away decades and decades of how we think things work.

From what I am reading other people engaged in wishful thinking hope that either (a) Justice Kennedy will uphold Obamacare rather than blow up all the prior precedent, or (b) Chief Justice Roberts will uphold Obamacare under the more cynical calculation that at the end of the day no one in Washington really wants more power to go to the states. Chief Justice Roberts may also surprise us and admit that Obamacare is a political question, best left for the political branches to decide.



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