Historic Court Ruling on Health Care

Today's release of the U.S. Supreme Court ruling validating President Obama's signature health care overhaul marks a groundbreaking watershed in American history and the culmination of a process begun exactly 100 years ago by Theodore Roosevelt.  The United States has now joined the civilized countries of the world in establishing access to medical care as a national policy priority and commitment.  In simple terms, the principle at issue was whether when somebody is sick in this country they should be able to see a doctor, or not.  That has now been decided in the affirmative.  

As with other great progressive intiatives initially decried by conservatives such as Social Security and Medicare, if the Republicans are not able to win this year's election and overturn the law, it will likely attain immense popularity once its full provisions take effect.  The winners will be the American people, particularly the 50 million currently without health insurance.

The ruling is sure to engender an even higher pitch of furious opposition than has existed up to now from the hard Republican base.  But it will also give the President and his allies a second opportunity to win the public debate about the law and its real meaning for public health in the nation.  He and they must clearly do a better job of promoting the plan than they did the first time around. 

There is a good foundation to start from.  The public remains supportive of many of the Affordable Care Act's provisions. Popular features include carrying dependents on parents' insurance until age 26, that no one may be denied insurance due to pre-existing conditions, the prohibition against dropping expensive patients and against imposing lifetime caps, and the requirement that insurance companies spend at least 85% of their revenues on actual health care for customers. 

It will also be necessary to refute the many sensationalist and erroneous charges that have been brought against it.  People who currently have employer-provided health plans, who pay for their own privately-purchased insurance, or who are on Medicare or Medicaid should not see any change at all.  People will still be able to go to their regular doctor.  There are no "death panels."  People will have to purchase health insurance, but will receive subsidies to do so on a sliding scale based on their income.  A basic value of the law is responsibility: everybody needs health care at some point, so it's only fair that everybody contributes to its provision.  The Government Accountability Office calculated that many of the ACA's other provisions will act to reduce costs in the health care system as well.  Already in the past two years we have seen a marked slowing in the rate of escalating health costs. 

The High Court's decision removes the constitutional challenge to Obamacare, but not the political one.  That makes it all the more crucial for proponents to work for Barack Obama's re-election.  Only a Mitt Romney presidency and close to 60 Republican votes in the U.S. Senate (they currently have 47) are likely to reverse the health initiative now.  So while today's announcement is highly historic it does not end the story quite yet.  The last chapter will be settled on November 6--Election Day-- 2012.