Supreme Court Health Care Reform Decision: Choose Your Own Adventure

Remember the “Choose Your Own Adventure” books from when you were a child? At the end of each chapter you got to decide how the story continued by choosing an outcome and the overall story would change accordingly. Well unfortunately, a panel of unelected officials will be choosing our “adventure” tomorrow for us. This “Choose Your Own Adventure” story is epic in size and spans over 2600 pages making the length of the Bible pale in comparison (no messianic pun intended but possibly warranted). The cast of characters in this epic “story” is huge. We have a President whose re-election and legacy will be affected by the Supreme Court’s decision. We have insurance carriers that employ hundreds of thousands of people. We have healthcare providers that only want to practice medicine while maintaining a balance between risk (lawsuits) and reward (insurance reimbursements). Lastly and most importantly, we have the American people, which is a class that all of the above belong to being consumers of healthcare.

The Patient Protection and Affordable Care Act or PPACA, could be thrown out entirely and deemed unconstitutional. PPACA could be left intacta (sic on purpose, I couldn’t resist). The individual mandate could also be stripped. Although I am for a limited government and do not believe the Interstate Commerce Clause should be applied in the case of Obamacare, one of the worst outcomes would be for the Supreme Court of the United States (SCOTUS) to deem the individual mandate unconstitutional and leave the rest of PPACA in tact. Why you might ask? Just like in auto insurance, you need to have safe drivers paying in premiums that ultimately cover the claims of those who file claims. Since auto insurance is required by law in most states (notice the Interstate Commerce Clause has not been applied by the federal government to auto insurance since there is no political capital available there), you do not have the problem of only high utilizers buying insurance. In health insurance, unfortunately those that either have a high frequency of claims or severity of claims buy health insurance and those that rarely visit the doctor choose not too. The reason the individual mandate was included in PPACA was to force “healthy’ people onto insurance so the carriers could collect premiums from them in order to offset the high claims of those with pre-existing conditions who now must be covered by law that weren’t previously insurable. If the individual mandate is deemed unconstitutional and the carriers do not get the increase in premiums from the healthy people forced onto health insurance, premiums will ultimately go up for everyone, thus defeating one of the supposed primary purposes of Obamacare which was to stabilize health care costs.

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