New Castle News

John K. Manna

March 31, 2012

John K. Manna: What happens if health reform is scrapped?

NEW CASTLE — Nobody outside the Supreme Court knows for certain how the justices will rule on the Affordable Care Act.

Some legal analysts have concluded, however, that after three days of oral arguments this week, chances are the court will rule part or all of the law unconstitutional.

Some believe that only the individual mandate section of the law appears to be in trouble. Others, particularly those opposed to the law, believe if the individual mandate portion is ruled unconstitutional, then the entire law can’t stand.

That seems to be the thinking of Justice Antonin Scalia in arguing whether the court should try to save other parts of the law.

“Your really want us to go through these 2,700 pages?” he said during the arguments. “Is this not totally unrealistic?”

I didn’t have the privilege to argue the case in front of the court, but if I had the opportunity, I would have responded, “No, Justice Scalia, it is not unrealistic.”

But I suppose that is not considered proper protocol in the court, although a question deserves to be answered.

Scalia’s comment, though, brings into question how the court can rule the rest of the law unconstitutional if it doesn’t bother to consider what’s in it.

That aside, those opposed to the law want it to be repealed for any number of reasons: That it’s a government takeover, that it takes decision-making away from individuals and their doctors, that it’s too costly and that the current health care system is just fine.

The frightening thing is that if the entire law is thrown out, history has shown that Congress may do nothing to reform the system for some time.

While some may believe that’s a good thing, my advice is to be careful what you wish for.

Before Congress passed the Affordable Care Act two years ago, The New York Times published an article with the headline, “The Cost of Doing Nothing on Health Care.”

The article said that nearly every “mainstream analysis” calls for medical costs to continue to climb over the next decade, “outpacing the growth in the overall economy and certainly increasing faster than the average paycheck.”

The typical price of family coverage in 2010 was about $13,000 a year. The Commonwealth Fund, a nonprofit health care research group, said at the time that premiums are expected to increase to $24,000 by 2020, which would be about a quarter of the projected median income that year.

What that means is that more businesses may drop coverage for employees and that more individuals will be unable to afford insurance.

But that’s just a small sampling of what could happen if the entire law is declared unconstitutional. If the court does throw out the law, who will step forward to prevent the crisis from getting worse? And how long will people wait for something to happen?

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