A version of this was published in the Sky Hi News 12 18-19 2018
Last week a Texas federal judge ruled that Obamacare was unconstitutional. 67,000 in Colorado are now able to afford quality health insurance and get their coverage through the state exchange including Medicaid expansion. About a third of Americans have pre-existing conditions that must be covered by their insurance thanks to Obamacare. What now? It will take months if not years for this suit to be appealed and to make it to the Supreme Court. Given the GOP attempt to stack the lower federal courts and the Supreme Court with their loyalists, who knows what the ultimate outcome will be, but in the short term, Obamacare ( the Affordable Care Act, ACA) will be the operative health care plan. The forty seats gained by the Democrats in the US House of Representatives in the midterms will give them a strong majority in the next two years to come up with a plan, either a version of Medicare for All or a repair and revision of the ACA, and immediate protection of the ACA from the GOP suit. Whatever the House Democrats pass will likely be rejected by the GOP Senate which increased their majority by a couple of seats in the November midterms.
This suit has been in the works for some time before the midterms. It was a scheme hatched by the GOP that had failed to get Congress to do their dirty work, thanks to Sen. John McCain’s thumbs down vote on repealing the ACA, and to get it done through the courts instead. Filing the suit were twenty GOP state attorneys general, some who later lost their party’s seats over the ACA suit support in November.
The political fallout in 2020 will put the GOP on the defensive no matter who their candidate may be. The GOP will be far more at risk of controlling both houses of Congress in 2020 than they did in November. They will have many more Senate seats in purple and blue states up for election than they did in 2018. The GOP seems not to have learned a lesson in 2018 midterms when the issue of their hostility to coverage of pre-existing conditions and continuation of Obamacare and their failure to provide a replacement were a major issues in flipping many of the state and House races blue. It was the top public policy issue on voters’ minds by all polls.
If the GOP suit makes it through appeals and the Supreme Court, coverage of pre-existing conditions, affordable insurance premiums for 20 million people, removing caps on coverage, requiring young adults to be covered, Medicaid expansion to the near poor, coverage of mental health and substance abuse, and more, would be dead. In pre-Obama care insurance coverage, pregnancy was considered a pre-existing condition and insurance often charged more for women’s health insurance. The GOP began gathering support for the suit when Obamacare was younger and public opinion swallowed their fear tactics that there would be death panels and that they could not choose their doctors or keep them. With personal experience they appreciated the benefits, affordability and did have more choice of doctors than they thought they would have so public opinion shifted to majority approval of Obamacare and over 60% approval of each if the major separate protections the ACA provided. They saw repeal of Obamacare was worse for their pocket books than having Obamacare warts and all.