On June 25, 2015 the Supreme Court upheld the provision for subsidies in the Affordable Care Act regardless of whether the insured procured their insurance coverage through their own state exchanges or were forced into the federal exchange as their own state’s demented leadership refused to establish an exchange.
This ruling makes clear the winners and losers in this ongoing battle over trying to legislate the availability of health insurance for millions of Americans previously denied access, whether due to pre-existing conditions or lack of affordability.
WINNER————–Chief Justice John Roberts whose concise, common sense opinion sliced through all the nonsense of those who brought the lawsuit out of spite, not out of genuine concern the law was harmful. Of course that brought the enmity of conservatives, some of whom (okay a really tiny portion of whom) believe the Good Justice was blackmailed or worse.
LOSER—————-Justice Antonin Scalia whose sputtering dissent, with phrasing like “interpretive jiggery-pokery”, reminds one of a pillar of the community found with his pants down in the local whorehouse amongst a bevy of belles but who would have you believe he was about to lead them in prayer.
WINNER————-President Barack Obama whose signature legislative accomplishment has survived yet another insidious but withering attack from the forces of politics, not of righteousness.
LOSERS————-Republican candidates for their party’s Presidential 2016 nomination who collectively and figuratively had pie shoved in their faces as again their predictions for the demise of the ACA were dashed on the rocks of futility with reactions ranging from the ridiculous to the ridiculous, nothing sublime remotely within their capacity to bloviate. Several shared their opinions via Twitter which proves once again twitter is for twits.
WINNERS………..American Citizens who now have reason to feel more secure in the knowledge that it is less likely they will face either financial ruin from receiving health care when they are not insured and that the availability of such coverage will inure to their physical and mental benefit…even in terms of saving lives… by being able to obtain treatment.
Gee, imagine that, a federal law that actually is good for the lives of ordinary people.
Economist Paul Krugman highlights the way the law is working after only two full years of implementation.
……….The Affordable Care Act is now in its second year of full operation; how’s it doing?
The answer is, better than even many supporters realize.
Krugman cites, among other positives, the expansion of coverage to as many as 15 million Americans, Also
Too, instead of a budget buster as the rampaging elephants would have you believe, it has helped in lowering the federal deficit and, if repealed, the deficit would rise again.
Krugman does not deny there are some difficulties, but not insurmountable ones. So long as a number of states refuse to expand Medicaid (placing a huge burden on state and local taxpayers, see http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/6/24/not-expanding-medicaid-can-cost-local-taxpayers) millions of the most desperate are still denied coverage.
He further speaks of premiums, which is a contentious issue, no doubt. However, the Commonwealth Fund found that the average increase in premiums for coverage under the ACA from 2014 to 2015 was ZERO.
Now average does not mean no increases for anyone anywhere. Anecdotal evidence of large premium hikes are plentiful, especially in internet forums. And even the study above reports substantial increases in some states with lower costs in others.
Which brings me to my real point about WINNERS & LOSERS.
So long as health insurance coverage in the United States is in the hands of private, mostly for profit companies, together with the ability of individual states to thwart the purpose of the Affordable Care Act and in light of the vagaries of state laws, insurance regulations, and insurance commissioners, there will be WINNERS and LOSERS in the game of health inusrance coverage and thus health itself.
The health and welfare of our citizens should not be subject to gamesmanship with keeping score a regular and necessary part of it.
This nation needs to wise up and create a system with true universal coverage. This could be achieved through a single payer system as our successful Medicare program could be expanded by making everyone eligible. That is my personal preference.
There are also hybrid systems such as in Australia with mandated coverage for all supported by general revenue taxes, a levy equivalent to our Medicare tax, and private insurance for some.
To me the chief flaw built into the ACA is that it is vulnerable to wanton attacks for purely political purposes, none of which have had either the intent or the ability to actually improve health care coverage in this country.
Of course the saddest part of these attacks is that the assailants simply do not care what harm they cause.
We can acknowledge that no system can be perfect. But our current system, even with the successes of the Affordable Care Act is still far below perfect.
Now, as we adjust to the reality of the ACA it will becvome ever more evident that we have a ways to go.
Let’s make WINNERS of the vast majority of our citizens and consign the LOSERS who oppose a better healthcare coverage system to the back pages of history where they belong.WINNE