No one knows how the Supreme Court will rule on Obamacare. But let’s assume that the Court does end up striking down the individual mandate when it releases its opinion this summer, and perhaps along with it Obamacare’s “guaranteed issue” and “community rating” provisions (which together say that insurers can’t avoid offering policies to those with expensive preexisting conditions and cannot charge them any more for those conditions). And let’s assume that the Court leaves the rest of the 2,700-page monstrosity intact. This is certainly a realistic scenario.
In that event, Obamacare would still increase federal spending by about as much as (and quite possibly much more than) it would now. According to the Congressional Budget Office, Obamacare’s “coverage provisions” alone, mostly in the form of its taxpayer-subsidized “exchanges” and its massive and underreported expansion of Medicaid, would cost a colossal $2 trillion (and change) in Obamacare’s real first decade — 2014 to 2023 ($1.753 trillion from 2014 to 2022, plus more than $265 billion in 2023). These coverage provisions wouldn’t get much cheaper, and could get a lot more expensive, without the individual mandate.
Given that Mitt Romney’s own health-care overhaul in Massachusetts also offers huge taxpayer-funded exchange subsidies and also expanded Medicaid coverage in the Bay State, if Romney is then the Republican nominee, would he be committed to repealing such provisions in Obamacare? Romney said just last week that we need “to abolish” Obamacare, “root and branch.” But if the Court snips away the most visible part of Obamacare and removes it from public view, would Romney still be determined to pull out the rest, and would he make it a centerpiece of his general-election campaign?
Since Romney has said very little about Obamacare’s massive exchange subsidies and Medicaid expansion, and not a ton about Obamacare generally, these would seem to be fair questions for GOP voters to ask.