Supremes’ Obamacare ruling: What me worry? Why we worry
Political America waits on tenterhooks for the next 24 hours to learn how the Supreme Court will rule on the Obama healthcare reforms.
Why should we care? It’s summer!
But really: There are plenty of pragmatic, historical, and political reasons to care. What happens tomorrow will likely affect whether you and your relatives can get, or afford, health insurance. It may well determine the outcome of the election in November. It will shape the next round of the debate over how Americans pay for the kind of society they want. And it will tell us how far the Supreme Court is willing to go down the road of what James Fallows — not a rash man — has called a “long-term coup.”
But the biggest reason we should care about tomorrow’s ruling is a psychological one. The Obama health plan — for all its compromises and limitations — represents an increasingly endangered species. It’s a large-scale effort to solve a major social problem with (mostly) smart, (mostly) efficient policies — a law that leverages the power of the American people, working through the government they elect, to make their world better. This is now such a rarity in American politics that if you’re under 40, you’ve basically never witnessed it.
In other words, the survival of the Obama health reforms isn’t only about the particulars of the health insurance debate. It’s about whether we have any hope of working together to tackle all the other vast problems that we know we aren’t going to solve through individual action alone. That includes pretty much everything we write about here at Grist, from bringing down climate-change-driving carbon emissions; to rethinking our industrial food system; to expanding our transportation options and revamping our energy grid; and on and on.
These things demand not just personal choices but collective will. Collective will waxes when it achieves its ends and wanes when it’s stymied.
If the conservative machine manages to derail the health reforms, the message is clear. Activists? Give up — you’re wasting your time. Idealists? Dream on! Capitalist individualism is the only game in our town. If it proves ineffectual in solving our national problems, well, we’ll all go down together, clutching the Constitution in our air-conditioned SUVs — except for the increasing percentage of the population that can’t afford the AC, the vehicle, or the fuel.
Is the U.S. still able to apply big common solutions to our big common problems? The court’s ruling may well answer that question — and there’s a strong possibility it’s going to answer “no.”
So what will happen tomorrow? Plenty of pundits think the court will throw out much or all of Obamacare; many obviously view that as a big defeat for the president and his allies, but some argue it will invigorate them, help them in November, and give them a chance to push for a purer government-run “single-payer” health plan. (Not going to happen with the current Congress, though.) You can also find pundits who think the court will uphold all or much of Obama’s law, though again they’re divided over whether this helps or hurts the president and the cause of health-insurance reform.
My bet, which is worth almost nothing, is that the Supremes will hand down a sweeping ruling against Obamacare. The conservative ideologues who now control the court do not shrink from the big battles, and to them, this is Gettysburg, Waterloo, and Stalingrad rolled into one. Why should they content themselves with half-measures? It’s not every day that you get an opportunity to win a decisive match in the long struggle between public responsibility and private power that has shaped American history.
But isn’t the court about, like, the law? Why assume that the conservative justices are approaching this as partisan players aiming for a maximal win? Well, here’s why: That’s the way every phase of this conflict has played out over the last quarter century.
At the heart of the legal conflict the court will resolve lies the “individual mandate” — Obamacare’s requirement that everyone in the U.S. get some kind of health coverage. The individual mandate is a deeply conservative approach to the healthcare issue, one that emerged from right-wing think tanks in the 1980s as a business-friendly alternative to the much-feared “single-payer” approach, where the government just extends Medicare-like coverage to the entire population. Republicans and conservatives embraced it en masse, and Democrats largely opposed it.
Then came the Clinton impeachment fight, the Florida election debacle of 2000, the politicization of 9/11, the Bush imperial presidency and its wars — a decade and a half of conservative aggression and progressive retreat. The right woke up after Obama’s election to realize that it had succeeded in moving the goalposts. Obama, aiming to seize the middle ground and come up with a plan that some Republicans might back, said, “Okay, let’s go with the individual mandate; it’s not perfect but it’s a lot better than nothing.” A Democratic president whose top priority was passing a healthcare law was now embracing the conservative policy prescription, much to many of his own supporters’ chagrin.
So if you’re a conservative Republican, what do you do? If your aim was to solve the problem of getting health care to all Americans, you’d just notch the win and line up behind the Obama plan, which used to be your plan. What we learned since 2008 is that the right is playing an entirely different game. Obama and his supporters were playing to pass a healthcare law; the Republicans were playing to beat Obama. (Side note: This argument is partially inspired by an excellent recent post over at Talking Points Memo. Couldn’t find the link to add here. If you’re reading this and you remember it, send it on!)
And so the red-state world set out to transform the individual mandate from a market-based alternative to “socialist” collectivized medicine into what it is today — a conservative-bogeyman nightmare of, um, “socialist” collectivized medicine. Along the way, conservatives determined that this concept that their own wonks had devised was in fact an unconstitutional overreach, then re-engineered the political landscape to prepare for its legal destruction.
This is a gambit that’s all too familiar to those of us who have followed the climate fight over the last two decades. Long before the shapeshifters of the intellectual right worked this transubstantiation on their own healthcare prescription, they’d had a perfect dress rehearsal: They’d done exactly the same thing with the concept of “cap-and-trade,” a market-based alternative to more aggressive state-enforced carbon emission rules that morphed over the course of a few years into a conservative-bogeyman nightmare of aggressive state intervention.
And it worked — beautifully. Utter the phrase “cap-and-trade” in any politically heterogeneous crowd today, and the right side of the house will grimace. The people who actually care about dealing with carbon emissions to stop the climate from going haywire were left wringing their hands; their opponents marched along to the next fight.
Today, that fight is over health care. But even if you don’t care about health insurance or haven’t followed the details of this policy argument or can’t see how any of it affects you, don’t be fooled: If the anti-Obamacare gang wins this one, they’ll move right on to the next issue. They’ll roll back common-sense environmental protections, cripple government efforts to smarten cities, and block food reforms. They won’t rest until they’ve scoured all prospect of collective action from our future.
All of which is a good reason to pay attention to how the Supreme Court rules tomorrow, and to how your senators and congresspeople clean up any resulting mess — or don’t.