Skip to main content
obamacare

Br’er Rabbit: “Please, please Br’er Fox, whatever you do, don’t throw me in that briar patch!”

President Trump, and no doubt some or all of the new 6-3 conservative majority on the Supreme Court, are practically salivating at the chance to finally take down the Affordable Care Act (aka Obamacare) after ten years of successful operation and multiple failed Republican attempts to kill it by legislation. They should take care what they wish for.

Obamacare as enacted was an awkward compromise in a vain search for Republican votes. That search entailed denying Medicare and Medicaid the authority to negotiate drug prices with pharmaceutical companies, and forgoing any sort of public option. So the system remained largely under the control of Big Pharma and the major health insurance companies. It still got no Republican votes. Even so, it did allow millions of previously uninsured people, including those with preexisting conditions, to get insurance.

The Court and the Republican Congress subsequently forced other changes to further weaken the law, most particularly repealing the mandate for individuals to have some insurance, and the requirement that states accept the expansion of Medicaid.

At this moment, then, Obamacare is a rickety remnant of a flawed law. Having it is still better than the alternative proposed by Trump and the Republicans, which is no law at all. 

Scroll to Continue

Recommended Articles

At this moment, then, Obamacare is a rickety remnant of a flawed law. Having it is still better than the alternative proposed by Trump and the Republicans, which is no law at all. The health care system would simply be left to work things out, surely to the benefit of Big Pharma and Big Insurance, and to the detriment of hospitals, doctors and patients.

The Court is to consider the suit to sink Obamacare right after the election. Their ruling will come early in 2021, presumably as Joe Biden is working on legislation to improve it, as he has promised (I discount a Trump victory).

Suppose the Court’s conservatives really do just throw the whole thing out, as Trump and the Republican Attorneys General have asked.

This would be a great gift to Biden and the Democrats, because it would free them from having to work out ways to incrementally improve Obamacare. They could start from scratch, with fresh information from the Court about its objections to Obamacare, and with no need (I’m assuming a Democratic Senate) to cater to the Republicans. They would probably come up with something approaching a Medicare for All plan, but with concessions to the shrinking number of people who still have employer-provided health insurance. The whole awkward and expensive system of state health insurance markets would no doubt go away.

Employers are already rushing for the exits from providing health insurance to their employees (who are increasingly designated independent contractors anyway). So the companies would be only too happy to yield the field to Medicare. And the erstwhile employees would have access to insurance at much lower cost than in the state marketplaces. Hospitals and doctors could greatly reduce their administrative overhead by not having to work with dozens of private insurers.

impeachment unavoidable

Biden should be channeling Br’er Rabbit.

John Peeler