It was the kind of spectacle that policy wonks savor – three days of complex and abstruse arguments before the U.S. Supreme Court on the constitutionality of the Patient Protection and Affordable Care Act (PPACA), commonly known as ObamaCare.
To cite a question that occupied a whole day of testimony: If the federal government can compel you to buy health insurance, can it also compel you to buy broccoli – or anything else that it deems to be in your best interests?
Should the Supreme Court uphold the law, it will signify that the act has met the minimal standard of constitutionality. Nothing more. The debate over constitutionality, however it is resolved, should not obscure the fact the PPACA is a really bad law. Let us count the ways that it violates basic principles of sound policy.
1. It exemplifies a legislate-in-haste-repent-at-leisure mentality. Few Senators and Congressmen had time to read the 2,700-page bill before it was brought to a vote. Then House Speaker Nancy Pelosi famously stated, “We have to pass the bill so that you can find out what’s in it.”
2. It violates the principle of impartiality. The same rules should apply to everyone. Already the administration has granted a long list of exemptions to various companies and unions.
3. It grants extraordinary powers to unelected bureaucrats to micro-manage health care and health insurance down to the smallest details of what is covered and what is not. Recently, the Department of Health and Human Services dictated that employers, including religious organizations, must cover contraception and abortion-causing drugs in their health plans. Apart from any moral objections to such provisions, why should the federal government tell employers and employees what their health insurance has to cover?
4. Good public policy would encourage health care consumers to shop around and purchase insurance policies that are best suited to their own needs and spending priorities. The PPACA does the opposite. Decision-making power is turned over to bureaucrats, who pay no price for decisions that are costly or wrong-headed.
5, 6, and 7. Good public policy does not raise false expectations. Backers of the health reform bill violated this principle three times over. They promised a) anyone can “keep their plan if they like it;” b) the plan would mandate many new benefits and still reduce the average family premium by $2,500; and c) that it would not add “a single dime” to the federal deficit.
According to a McKinsey & Co study, a third to a half of employers plan to stop offering health insurance beginning in 2014. Another study concludes that a typical family health insurance plan costing $12,300 today will cost more than twice that by 2019. And finally, the administration has grudgingly acknowledged spiraling costs under its plan.
8. Good public policy avoids ticking time bombs. The health-care law is filled with them.
The legislation will increase Medicaid enrollment by an estimated 24 million new beneficiaries by 2015. Missouri and other states struggling to balance their budgets will pick up a significant share of the cost.
The law includes a massive new health entitlement/income redistribution program for families earning more than three times the poverty level. In 2014, it will channel up to $3,000 in taxpayer funds to families making up to $95,000.
PPACA discriminates against young people, forcing them to purchase health insurance at inflated prices in order to subsidize older beneficiaries. Simultaneously, the law imposes severe penalties on young people who use Health Savings Accounts to secure benefits for themselves in later years.
9. The PPACA is fiscally irresponsible. It includes a raft of new taxes. But these appear to be wholly inadequate to the task of paying the bill for over-promising and extending new entitlements to tens of millions of people. That leaves rationing as a last resort, and the government’s own reports contemplate major cutbacks in Medicare spending down the road.
10. The Affordable Care Act is truly unaffordable . . . and unsustainable. Perhaps the Supreme Court will strike it down. But whatever the Court decides, that does not excuse our elected representatives from their responsibilities. Our government should not erode our freedoms, degrade our quality of life, or bankrupt our future. The PPACA does all of those things. If not struck down, it should be repealed.
Andrew B. Wilson is a resident fellow and senior writer at the Show-Me Institute, which promotes market solutions for Missouri public policy.