Politics & Policy

The Court Reveals Obamacare’s Unworkability

Without the Medicaid expansion, the feds will have to subsidize millions more.

This column is being written in the midst of a power outage that has reduced many parts of the mid-Atlantic to primitive conditions. I have no right to complain. We installed a small generator after the last big power failure (“Snowmageddon”) and at least have been able to sleep in air-conditioned comfort. We sincerely pity the million-plus people in our area and surrounding states who are coping with 95-degree temperatures without any power at all.

So, while we are definitely among the lucky ones, the “Derecho” outage has managed to short-circuit our 21st-century lives anyway. Only the bedrooms are cool. The phones, Internet, and televisions are dark. Even cell phones didn’t function for 24 hours. Gas stations are closed. Supermarkets are dark and selling only non-perishable items. If you want meat, vegetables, eggs, or milk, you’ll need to drive another half hour.

The Wall Street Journal wasn’t delivered, and reading the Washington Post by itself is like choking down medicine, especially in an election year. The dog is very sick, and we cannot contact the vet because the phones are dead. (Update: The dog is in a veterinary emergency hospital, which thankfully does have power.)

Why does the nation’s capital go through this convulsion so very often? People who live in other great cities report that they have seen decades go by without significant power outages. I’ve heard that they have trees, too. What is it about Washington? We gave Baghdad freedom and got their power grid in exchange? It’s been four days and they’re saying it may be seven before power is restored. At the very least, we should be asking how much of an investment it would be to bury all the power lines. I would certainly prefer to spend precious tax dollars on that rather than on Obamacare.

Speaking of Obamacare, there’s a theme among some commentators that Roberts achieved a brilliant, John Marshallesque long-term victory for conservatives. Don’t fret, they soothe. Roberts is playing chess while we’re all playing checkers. Just wait till he votes next term to overturn affirmative action and the Voting Rights Act.

Not so fast. If forced to choose between a correct vote on affirmative action or one on Obamacare (and if I believed I could rely on Roberts for either), I would have chosen the latter. There will be many more opportunities to overturn affirmative action. But Obamacare was arguably much more important to the success of self-government. Affirmative action is morally wrong. But it won’t bankrupt us, and it doesn’t expand the reach of the federal government.

Whatever words were written about the Commerce Clause, the result speaks louder. Speculation about future Roberts votes is just that. For now, we have reason to worry that, at worst, he succumbed to intimidation by the Left and changed his vote to keep the Court from being vilified, and, at best, that he engaged in shoddy scholarship.

Still, the decision does force the Obama administration to acknowledge what it has steadfastly denied — that Obamacare raises taxes on the middle class. Also, two liberal justices did agree that there are limits to federal power over the states vis à vis Medicaid. That’s notable. So often it’s conservative justices who disappoint their side. But in this case, which hasn’t gotten much attention, two liberals agreed that the feds cannot bully the states.

The Medicaid feature of the decision may also force the truth about the law to emerge more quickly than would otherwise have been the case. Without the capacity to force states to expand their Medicaid programs, the federal government will be left with the responsibility to provide subsidized health-insurance policies to millions more people.

Those with incomes up to (effectively) 138 percent of the poverty line were to have been covered by Medicaid. Those with incomes (roughly) between 100 and 400 percent of the poverty line were to use the exchanges. When CBO first scored the bill, it estimated the subsidies for the exchanges based upon the Medicaid expansion. Without it, the subsidies for those purchasing in the exchange market will have to rise considerably. As Charles Blahous of Economics 21 explains, “Without the . . . Medicaid expansion, the law’s health exchange subsidies might be fiscally unworkable. The Supreme Court may have just set in motion a chain of events that could lead to the law’s being found as busting the budget, even under the highly favorable scoring methods used last time around.”

“Unworkable” was always a good shorthand for the law. Now, the Court so praised for ratifying Obamacare has simultaneously made that verdict unavoidable.

Mona Charen is a nationally syndicated columnist. © 2012 Creators Syndicate, Inc.

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