Health-care reform: Main issue after 2 years is, will it survive?
Health-care reform law is extolled by the White House for improving lives and is the object of scorn from the GOP. But the looming Supreme Court battle overshadows the partisan debate.
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“This presidency has been a failure. At the centerpiece of this failure is this piece of legislation, ObamaCare,” said Romney while campaigning in Louisiana.Skip to next paragraph
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Of course, Romney has his own health-care problem, in that while governor of Massachusetts he signed into law a health bill often credited with serving as the model for Obama’s national legislation.
In an opinion piece for USA Today this week, Romney outlined his own plan for national health reform, saying that among other things he would offer a tax benefit to individuals to buy health insurance on their own.
Romney added he would turn over responsibility for helping the poor, uninsured, and chronically ill to state capitals, instead of Washington.
“I favor giving each of the 50 states the resources and the responsibility to craft the health-care solutions that suit their citizens best,” wrote Romney.
Many of the most significant ACA provisions have yet to take effect, notes Kaiser Health News in a scorecard of what the law has delivered so far.
State-based exchanges, a kind of marketplace for individual insurance, aren’t supposed to be up and running until 2014, for instance. That’s when the US will start subsidizing the purchase of such policies for lower-income Americans.
Some parts of the bill that have already taken effect have exceeded expectations, according to Kaiser. The number of young adults whose coverage has continued on parental polices is almost twice the number predicted at the law’s passage, for instance.
Other provisions have underperformed. The White House estimated that 4 million small businesses by now would be receiving tax credits for their contributions to employee health plans. As of last November only 309,000 businesses had qualified for these credits.
Will all this be a moot point? It’s possible the ACA health care reforms will collapse if the Supreme Court strikes down the individual mandate at the heart of the bill. The requirement that individuals carry insurance makes economically possible such popular parts of the ACA as the provision that insurers cover people with pre-existing conditions.
Such a move by the Supreme Court would also mark a turning point in American constitutional law, according to Russell Wheeler of Brookings.
For decades many constitutional scholars have assumed that Congress has extensive powers to regulate US economic activity under the Constitution’s Commerce Clause. But if the justices reject the individual mandate, they’d be calling into question that interpretation of the law.
“If the court strikes down the individual mandate our constitutional law will take a 180 degree turn,” says Wheeler.
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