From the beginning, nearly every Republican and most Democrats knew that the Affordable Care Act (ACA), passed in 2010, would need to be changed. The Republicans always thought a complete repeal and replacement would be necessary, while Democrats thought they could tweak the law over time. The United States Supreme Court, however, has just dealt a knockout punch to the Democrats when it comes to their ability to write a replacement health care law.
Most opponents of the ACA believed the law would not withstand a challenge to its constitutionality. Surprisingly in a 5-4 decision, the Supreme Court upheld the law in 2012. Opponents said it is illegal for Congress to force any American to purchase a product, which the ACA did by forcing every American to buy health insurance or pay a fine. This was called the “individual mandate.” Therefore the law was unconstitutional—or so the argument went.
But the high court’s logic in 2012 was that the individual mandate was not necessarily forcing an individual to purchase a product. Rather, Congress has the right to levy a tax. Once levied, it must be decided who pays the tax. The ACA levied a tax on all Americans who do not purchase health insurance. In this way, the court reasoned, the ACA individual mandate was constitutional. Therefore the entire law was constitutional.
In 2017, however, Congress passed a tax reform law that repealed the “tax” and penalty associated with the individual mandate. As such, all Americans are no longer forced to purchase health insurance. Since Congress made no other changes to the ACA, opponents of the ACA argued that the law is now unconstitutional.
In December 2018, a Texas federal court agreed. The court found that the entire law is unconstitutional. Now the Supreme Court has agreed to hear the case on appeal. The Democrats thought the justices would hear the case in early spring of this year and render their decision in June. If the court sided with the Texas decision and voided the ACA, healthcare would become a massive issue in the November elections.
The Democrats thought this would be a big plus for them because they believe voters favor their approach to healthcare policy over that of the GOP. The Democrats also believe healthcare reform played a significant role in their congressional wins in the 2018 election.
Naturally, Democrats asked the Supreme Court to fast-track the ACA appeal case. But the court apparently saw through the ploy and last week rejected the Democrats’ plea, meaning the case will be heard after the November election.
Needless to say, this is a major blow to the Democrats.
Common sense would suggest that congressional Democrats and Republicans should have gotten together after the 2018 court decision and either drawn up new legislation to replace the ACA or hashed out a compromise plan to fix the current law. But the toxic division that exists between the two parties made that impossible.
Hoping to exploit division for partisan gain was a big mistake for the Democrats, who have now spent months attempting to impeach a president for unimpeachable acts. They blew a huge opportunity.
If the impeachment ends with an acquittal for President Trump—which is the likely outcome—and if the Democrats perform poorly in November, a new health care law could be implemented with little or no Democratic input. Recall how Democrats passed the Affordable Care Act in 2010 with absolutely no Republican support.
One scenario in November is that Trump is re-elected with a large majority. The country is so fed up with the lack of progress by the Democrats in the House, that the house flips back to a GOP majority. Trump’s coattails could help with this.
Now suppose the Republicans not only hold their majority in the Senate but increase it. That means the GOP would be in complete control of writing any new health care law.
The Democrats will have missed their opportunity to devise a bipartisan bill. It often appears that President Trump has the mind of a Republican but the heart of a Democrat. As such, the Democrats in the House could have come to an agreement with the GOP-controlled Senate and Trump likely would have signed a compromise bill.
Now that they have raked the president over the coals, he will be in little mood to compromise. And that’s a big problem for the Democrats, not only for the election but in terms of leading the country after the election, especially when it comes to solving the healthcare mess. It’s too bad.