If the healthcare law is overturned, universal healthcare is dead forever

[Mitt Romney's Hair]

From the updates I've read, it looks very likely that a 5-4 vote against the mandate will occur now.

As already mentioned, this will make Mitt's campaign so much easier, removing a huge obstacle for him. And this would be a train wreck for Obama - essentially his first two years in the trash, along side his (mostly) failed stimulus.

At this rate, the guy will only be able to run on economic numbers, and even those - while a slight improvement - aren't good.....

Obama needs to hope it's not struck down. If it his, I think he's lost re-election and he is destined to be remembered as the weak president he has ultimately been.

[True Federalist]

From the updates I've read, it looks very likely that a 5-4 vote against the mandate will occur now.

As already mentioned, this will make Mitt's campaign so much easier, removing a huge obstacle for him. And this would be a train wreck for Obama - essentially his first two years in the trash, along side his (mostly) failed stimulus.

At this rate, the guy will only be able to run on economic numbers, and even those - while a slight improvement - aren't good.....

Obama needs to hope it's not struck down. If it his, I think he's lost re-election and he is destined to be remembered as the weak president he has ultimately been.

If only the mandate is struck down then whoever wins the White House in November is going to have quite the mess on their hands.  (No way anything gets done to clean up the mess before the election.)  The Republicans need to hope that if it is struck down that the Court does not find the law to be severable so that it is a total strike.  Even if they win all three branches in November, the Democrats will have enough Senators to filibuster the GOP from doing anything to clean up the mess without extracting some major concessions on what will be a must pass bill.

[J. J.]

Well, if the judges decide to overturn this law by a 5-4 margin, the only significant binding precedent will have been Bush v. Gore for having led to the current composition of the Supreme Court. Schade.

I think it might be like Bush v. Gore, a 7-2 vote on the mandate, and possibly a 5-4 decision on the rest.

As already mentioned, this will make Mitt's campaign so much easier, removing a huge obstacle for him. And this would be a train wreck for Obama - essentially his first two years in the trash, along side his (mostly) failed stimulus.

At this rate, the guy will only be able to run on economic numbers, and even those - while a slight improvement - aren't good.....

Obama needs to hope it's not struck down. If it his, I think he's lost re-election and he is destined to be remembered as the weak president he has ultimately been.

Yes, I think this could do two things, strengthens Romney, slightly, and weakens Obama, greatly.

On so many fronts, having this struck down destroys Obama.  The presumed "strengths" of Obamacare.

1.  While this isn't a direct effect of any SCOTUS decision, a selling point is that Obamacare would become popular.  It hasn't.  It's a drag on the Democratic Party.

2.  A strike down will make Obama look [even more] ineffective.  He will have four years and nothing to show for it.

3.  It plays into the "Obama is a Socialist willing to violate the Constitution" argument.   This is even worse since he claimed to be a "constitutional professor."

4.  Because some form of "socialized medicine" has long been a major piece of Democratic policy, the Holy Grail of it, it has a fair chance of discrediting the party as a whole.

I think #1 and #4 have further reaching effects than just Obama.

[Senator Sbane]

I don't see why a decision that makes clear that making people buy healthcare insurance is an exception to the rule, cannot be reached. I think it's quite clear the healthcare insurance market is something very different from most of rest of commerce.

[retromike22]

If Medicare is already constitutional, why not just expand Medicare for everyone? That seems to be better than a individual mandate.

[Invisible Obama]

How are Republicans going to explain how they intend to remedy pre-existing conditions returning to the fold? That is one of the top successes of the health care law. They pushed for this case and have no solutions for what to replace it with. Romney doesn't gain from this either way, it's just not an election changer.

[muon2]

If Medicare is already constitutional, why not just expand Medicare for everyone? That seems to be better than a individual mandate.

Medicare is single payer, and even the Obama White House has been unwilling to go down that road.

[Torie]

How are Republicans going to explain how they intend to remedy pre-existing conditions returning to the fold? That is one of the top successes of the health care law. They pushed for this case and have no solutions for what to replace it with. Romney doesn't gain from this either way, it's just not an election changer.

Their insurance premiums for a certain level of coverage need to be subsidized more on a means tested basis. That is the Pub response - at least among those who are serious about the issue, rather than just demagoging for the moment for short term gain. The Pub response is more market oriented. The Obamacare edifice is wholly unnecessary to achieve the objective - and what I particularly despise about Obamacare is the cross subsidy from the impecunious young, to the less impecunious old as a general rule. The youngs will be subsidizing me for example. It's ludicrous. And any plan in the end requires some sort of rationing, but that is most pressing with Medicare.

In any event, the status quo is the pre-existing conditions folks of limited means go to the emergency room, and don't pay their bills. So they are being "dealt" with, just not in any coherent or sensible manner.

[muon2]

How are Republicans going to explain how they intend to remedy pre-existing conditions returning to the fold? That is one of the top successes of the health care law. They pushed for this case and have no solutions for what to replace it with. Romney doesn't gain from this either way, it's just not an election changer.

Their insurance premiums for a certain level of coverage need to be subsidized more on a means tested basis. That is the Pub response - at least among those who are serious about the issue, rather than just demagoging for the moment for short term gain. The Pub response is more market oriented. The Obamacare edifice is wholly unnecessary to achieve the objective - and what I particularly despise about Obamacare is the cross subsidy from the impecunious young, to the less impecunious old as a general rule. The youngs will be subsidizing me for example. It's ludicrous. And any plan in the end requires some sort of rationing, but that is most pressing with Medicare.

In any event, the status quo is the pre-existing conditions folks of limited means go to the emergency room, and don't pay their bills. So they are being "dealt" with, just not in any coherent or sensible manner.

There's a local bottom-up way to deal with this as well. In my county the covered pool has been greatly expanded by having the government partner with local hospitals and clinics. It's in the the hospital's financial interest to provide services that are lower cost than treating uninsured in the emergency rooms. The government steers clients to cost-effective options as needed. The net effect is about a 1-to-9 leverage of tax dollars to private services.

[○∙◄☻¥tπ[╪AV┼cVê└]

Forever, no. But it could be a while. Especially since Democrats saw their failure to pass health care in 1994 as the reason that election went so poorly, and so looked to pass some random bill with the name reform in it to avoid another 1994, and they did avoid another 1994, 2010 was worse.

[anvi]

The idea that sick people who have no insurance can just routinely use emergency rooms for their care is false. The provisions of EMTALA only require hospitals to treat such persons if they are at severe risk of death or in active labor, and even then they need only be treated till their immediate condition is stabilized. While there are emergency rooms that treat more, it's completely legal for them to turn patients away if they don't meet these conditions, and they often do. Many people in such circumstances suffer from serious chronic conditions for long periods of time that would otherwise be treatable, but end up only being accepted for emergency room care when it's too late to successfully treat their conditions. A rather large number if American citizens lose their lives every year because of these circumstances. So the notion that we can comfort ourselves with the argument that there are only problems of economic inefficiency bedeviling our system when it comes to the uninsured is a conceit. It's a moral issue, and I think a serious one.

[I left.]

The idea that sick people who have no insurance can just routinely use emergency rooms for their care is false. The provisions of EMTALA only require hospitals to treat such persons if they are at severe risk of death or in active labor, and even then they need only be treated till their immediate condition is stabilized. While there are emergency rooms that treat more, it's completely legal for them to turn patients away if they don't meet these conditions, and they often do. Many people in such circumstances suffer from serious chronic conditions for long periods of time that would otherwise be treatable, but end up only being accepted for emergency room care when it's too late to successfully treat their conditions. A rather large number if American citizens lose their lives every year because of these circumstances. So the notion that we can comfort ourselves with the argument that there are only problems of economic inefficiency bedeviling our system when it comes to the uninsured is a conceit. It's a moral issue, and I think a serious one.

Agree entirely, and it's not understandable in any way for me. Even if you have no moral problem with people dying in one of the richest countries in the world for lack of healthcare, it doesn't make economic sense. Nothing is free - and the way the system operates in the U.S. right now makes it unnecessarily expensive AND non-universal.

[muon2]

The idea that sick people who have no insurance can just routinely use emergency rooms for their care is false. The provisions of EMTALA only require hospitals to treat such persons if they are at severe risk of death or in active labor, and even then they need only be treated till their immediate condition is stabilized. While there are emergency rooms that treat more, it's completely legal for them to turn patients away if they don't meet these conditions, and they often do. Many people in such circumstances suffer from serious chronic conditions for long periods of time that would otherwise be treatable, but end up only being accepted for emergency room care when it's too late to successfully treat their conditions. A rather large number if American citizens lose their lives every year because of these circumstances. So the notion that we can comfort ourselves with the argument that there are only problems of economic inefficiency bedeviling our system when it comes to the uninsured is a conceit. It's a moral issue, and I think a serious one.

But many uninsured do routinely stop at the ER for lack of an alternative. The best solution is to connect those people with a primary care physician. That overcomes economic inefficiency and works to identify conditions that could be effectively treated at an earlier point.

[Torie]

The idea that sick people who have no insurance can just routinely use emergency rooms for their care is false. The provisions of EMTALA only require hospitals to treat such persons if they are at severe risk of death or in active labor, and even then they need only be treated till their immediate condition is stabilized. While there are emergency rooms that treat more, it's completely legal for them to turn patients away if they don't meet these conditions, and they often do. Many people in such circumstances suffer from serious chronic conditions for long periods of time that would otherwise be treatable, but end up only being accepted for emergency room care when it's too late to successfully treat their conditions. A rather large number if American citizens lose their lives every year because of these circumstances. So the notion that we can comfort ourselves with the argument that there are only problems of economic inefficiency bedeviling our system when it comes to the uninsured is a conceit. It's a moral issue, and I think a serious one.

True enough, although the "emergency room" is packed with folks with conditions not so dire (I see now that Muon2 mentioned that above). The other backup is Medicaid - which is effectively rationed via hideously long wait times in practice all too often. I hope no one assumed I considered the lack of universal insurance (at least catastrophic insurance) to be a non problem due to emergency rooms and Medicaid, because that is not the case.  

Muon2 is also clearly right that the primary care physician system needs to be beefed up. Among other issues, we just don't have enough of those kinds of doctors and nurses. I would prefer that that be done through HMO's myself for the subsidized tranche were possible, so all the financial incentives are in the public interest, and the temptation for abuse minimized.

[Yelnoc]

Somebody probably already beat me to the punch, but the OP realizes "Obamacare" is in no way "universal", yes?