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What Would Happen if the PPACA Is Struck Down?

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This is the time when it seems obligatory for Supreme Court analysts to make predictions about how the Court will rule in the imminent health care ruling. Mine is the same — I have no idea. The case will come down to a justice with an erratic record on the relevant issues who didn’t show his hole cards at oral argument.

What is worth considering is what would happen if the PPACA, or its mandate, is struck down. We should first of all be clear that the mandate is necessary for the bill to work, for reasons Sarah Kliff details:

In 1993, Washington state passed a law guaranteeing all residents access to private health-care insurance, regardless of their health, and requiring them to purchase coverage.

The state legislature, however, repealed that last provision two years later. With the guaranteed-access provisions still standing, the state saw premiums rise and enrollment drop, as residents purchased coverage only when they needed it. Health insurers fled the state and, by 1999, it was impossible to buy an individual plan in Washington — no company was selling.

Not only should this settle the policy question, it should have settled the legal question. Unless you take the radical libertarian position that the federal government cannot regulate the health insurance market (or are a soldier in the even more crackpot libertarian War on the Concept of Insurance) the mandate is a necessary and proper part of a regulatory framework that is concededly constitutional. And, of course, the War on the Concept Of Insurance is incredibly stupid. Health care emergencies and long-term health care issues are distributed unpredictably without any regard to ability to pay, and the expenses involved would bankrupt all but the most wealthy. The pooling of costs and risks is fundamentally necessary, and while the PPACA is not my ideal means of accomplishing this there’s no constitutional requirement that policy fixes be optimal (particularly when the structure of American political institutions makes is impossible to enact them.)

Which brings us to another important point. The PPACA isn’t very popular. But this is somewhat misleading, in that the public supports most of the provisions of the bill but opposes the mandate, but the former are impossible without the latter. So while it’s superficially true that the public is comfortable with the Supreme Court striking down the PPACA, it’s also worth noting that if “the Supreme Court strikes down President Barack Obama’s signature health care reform law, 77 percent of Americans want the president and Congress to work on new legislation overhauling the system” and “[o]nly 19 percent of Americans want lawmakers to leave health care the way it is.” Much of the public — like some analysts who really should know better — seems to have the idea that if the PPACA is struck down it will be immediately replaced by the Magic Pony Plan With the Same Benefits and No Costs. In fact, Congress’ offer will be nothing, and especially not the fees for your long-term illness, which it would appreciate if you would head straight to bankruptcy court put up personally despite your negative net worth.

And, should anybody still be tempted to make a heighten-the-contradictions argument, let’s not forget where the burdens of the contradictions would fall.

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  • George bush’s feminism

    The case will come down to a justice […] who didn’t show his hole cards at oral argument.

    Indeed, to do otherwise would be uncouth!

  • Incontinentia Buttocks

    The PPACA isn’t very popular. But this is somewhat misleading, in that the public supports most of the provisions of the bill but opposes the mandate, but the former are impossible without the latter.

    I sleep better knowing that messaging is unpossible, so that this unfortunate state of affairs could not have been otherwise.

    • Scott Lemieux

      Well, the White House devoted an enormous amount of resources trying to educate the public about the PPACA. How did that work?

      • Blue Neponset

        If the other side had devoted no resources to messaging that might actually be a legitimate point. Do you ever look at things outside of a vacuum?

        • NonyNony

          I don’t think I understand your point. Could you clarify it?

          ’cause the way it looks now it sounds like:

          IB: The White House should have done more to sell this to the American people
          SL: The White House did a hell of a lot to try to sell it and it didn’t work
          BN: The opposition was also selling their own messaging, so your point is moot.

          I don’t see how your argument follows from Scott’s. I suppose you might be arguing that the White House should have done more than they did, but that’s not clear.

          (Personally I think the ball was dropped when the decision was made to make this a mandate to buy health insurance instead of a tax credit to give to people who have insurance – that would have solved the messaging problem, but the tax increase on people who don’t have insurance would probably have created its own messaging problem and I’m actually fairly positive that we’d STILL be where we are today if it had been done that way).

          • Incontinentia Buttocks

            Just to be clear, NonyNony:

            Proponents of the bill included not just the White House, but also Congressional Democrats, all of whom in the House and many of whom in the Senate faced very immediate political accounting in 2010. So I don’t think that this was entirely up the White House. My comment didn’t mention the White House because they are only a piece of the puzzle.

            Also: I’m not saying that anybody necessarily should have done more messaging. I’m saying proponents should have done a better job of selling the ACA. Whether that would have involved more messaging or just more effective messaging is a separate question. The issue isn’t the volume of messaging, but its effectiveness.

            • Hogan

              The issue isn’t the volume of messaging, but its effectiveness.

              There might be some kind of relationship between those two variables.

              • Incontinentia Buttocks

                There probably is, but it’s not 1:1.

                If I say “the messaging could have been more effective” it remains not particularly responsive to say “but they did a lot of messaging!”

                • Scott Lemieux

                  Well, the problem is that then the argument becomes an unfalsifiable tautology — if messaging didn’t work, it’s because the messaging wasn’t good enough. That’s fine in every individual case, but the fact that it never seems to work is a deeper problem.

                  Even leaving aside the data, I don’t think any plan that requires large parts of the public to acquire detailed information about policies and to understand it in the context of possible alternatives is remotely plausible.

                • Your last paragraph is crucial, as the argument advanced by IB, Doc Amazing, and others rests on, or seems to rest on, assuming that the average person devotes quite a bit more of their leisure time familiarizing themselves with the finer points of policy and political rhetoric than they actually do.

                • Scott Lemieux

                  As you can see from the links, there are health care experts at Harvard Law School who are OK with striking down the PPACA because it will lead to the Magic Pony Act of 2013. You think you’re going to convince the typical voter that they can’t just get a bill with the popular stuff and not the unpopular stuff with clever enough messaging, good luck with that.

            • NonyNony

              I don’t know how many Congressional Democrats were actually “proponents” of the bill rather than “people who are willing to vote for it, but aren’t particularly happy about voting for it”. The PPACA is one of those pieces of legislation that nobody seemed happy about because it was the result of a long series of ugly compromises, but that in a decade or so after (if) its implemented everyone who gave a tepid vote in favor of it will be lining up to take credit for it.

              And I think that the fact that most of the PPACA is actually popular shows a success of messaging. I don’t think that it’s at all surprising that the “you’re legally obligated to buy health insurance” portion is unpopular and I don’t know ANY messaging technique that would make it popular. It’s a compromise position that is far from anyone’s favored solution, so it’s no wonder that nobody really likes it. And if I’m polled and given a laundry list of items in the PPACA and asked which ones I like and which ones I don’t – well, I’m going to say that I don’t like the mandate. And I’ll still say that even though I understand that there wasn’t a way to really get all the good stuff I like about the PPACA without having that mandate in there.

              And I can’t imagine the kind of propaganda war that would have to be waged to change people’s minds about this one. It would be different if it were just a tax – then you can sell it as a patriotic duty/we’re all in this together sort of thing. But trying to sell a legal obligation to go buy insurance from a private company? I think even the guys who used to write ad copy for cigarette companies would find that a bit hard to sell.

              • Incontinentia Buttocks

                So you’re claiming that Congressional Democrats just didn’t want it badly enough? If one is going to be on the record voting for a controversial piece of legislation, this attitude you describe would seem to be worthy of criticism. Trying to run away from such a vote can’t — and didn’t — do Congresspeople and Senators a lick of good politically.

                • NonyNony

                  Yes that’s exactly what I’m claiming. I think watching how the Democrats in Congress acted with regards to the legislation bears that out too.

                  Most of them wanted to do something, and they were ultimately able to hold their noses and sign on to the final compromise. But I don’t think there was anyone in Congress who wanted to run out and champion the bill as it came out in the end.

                  And I don’t think it’s as much a question of them wanting to “run away” from the final bill as it is that they wanted to distance themselves from the various compromises that had to be made to pass it. So they might have wanted to take credit for the things that they saw as “good bits” but if that meant owning the whole thing then forget it.

                  But again – that’s different from the messaging strategy aimed at the public. Hell I might almost argue that that’s a problem of internal messaging within the Democratic Party – another example of the party not being able to sell an agenda to their own membership, let alone to the public at large.

        • So why is the vast majority of the bill’s provisions popular, then?

        • joe from Lowell

          If the other side had devoted no resources to messaging that might actually be a legitimate point.

          So, messaging by the White House is an incredibly powerful thing, except on those rare occasions in which the other side makes it argument, too.

          Thank you for this.

        • Scott Lemieux

          If the other side had devoted no resources to messaging that might actually be a legitimate point. Do you ever look at things outside of a vacuum?

          I’m talking about net effects. I concede the point that the BULLY PULPIT might be more effective if the opposition remained eternally silent, but who gives a shit?

      • Incontinentia Buttocks

        The fact that a particular messaging campaign didn’t work does not prove that messaging is impossible…especially given how well the opposition’s messaging campaign seems to have worked. I would agree that good messaging is not simply a matter of how many resources one invests.

        • Hogan

          The fact that a particular messaging campaign didn’t work does not prove that messaging is impossible

          Did someone say it is? Other than you, I mean?

          • Incontinentia Buttocks

            So everyone agrees that the state of public opinion on the ACA could have been different if the bill’s proponents in the White House and Congress had done a better job of selling it?

            Great! Glad to hear that nobody disagrees with me.

            • I “observe” that you continue to be the only one making any sort of assumptions about the fundamental nature of public opinion.

              • Incontinentia Buttocks

                Would you (or anyone else) agree that one of the following two statements is true?

                1) The public fundamentally misunderstands the ACA and there is nothing proponents could have done differently so that this would not be the case today.

                2) The public fundamentally misunderstands the ACA, but this needn’t have been the case if proponents had done a more effective job of explaining it to the public.

            • rea

              So everyone agrees that the state of public opinion on the ACA could have been different if the bill’s proponents in the White House and Congress had done a better job of selling it?

              No, everyone agrees that the state of public opinion on the ACA could have been different if the bill’s proponents in the White House and Congress had been able to do a better job of selling it

              • Incontinentia Buttocks

                Exactly, rea!

                I believe they could have. Others believe that it was impossible for them to have done so.

                • rea

                  So, then (1) you believe that it was possible, and (2) you don’t have a clue as to how it could have been done.

                • Incontinentia Buttocks

                  On what basis do you conclude that it was impossible, rea?

                • NonyNony

                  On what basis do you conclude that it was impossible, rea?

                  Probably on a similar basis that you use to conclude that it was possible.

          • Incontinentia Buttocks

            Did someone say it is? Other than you, I mean?

            See, e.g., Brien Jackson below, who not only says this, but is hopping mad that I don’t agree!:

            The problem is that you don’t even allow for the possibility that no form of “messaging” can change short term public opinion on, say, privatizing a portion of Social Security, and simply don’t engage the people who are operating under that assumption on these terms, ever. Which is why your constant evocations of “messaging” are just flat out tiresome and pointless. Your “observations” are a waste of time because those of us who are disagreeing with you simply don’t share your base assumption, so if you want to do more than beat that dead horse you actually do need to invest a little bit of energy in coming up with some sort of alternative theory that isn’t riddled with easily observable holes, otherwise the preponderance of evidence clearly suggests that you’re wrong.

            • Hogan

              “Messaging doesn’t accomplish much in the short run” is a very different claim from “messaging is impossible.” But if smoke from a burning strawman is what gets you high, carry on.

              • See also: America’s infatuation with David Broder’s Magic Pony, as Scott notes in this post.

        • chris

          I would agree that good messaging is not simply a matter of how many resources one invests.

          Sure — some positions are just a lot easier to convince people of than others. There’s a word for that; it’s “truthiness”. But if you’re stuck defending a low-truthiness position (whether or not it happens to also be true), you can’t just raise its truthiness by wishing.

          Attacking someone’s messaging skills because the low-truthiness position they tried to defend didn’t make great inroads into public opinion is a little like blaming teachers when a malnourished, stressed kid with functionally illiterate parents doesn’t get straight As. It may make you feel good, but fundamentally the drivers of failure were outside the scapegoat’s control.

      • Incontinentia Buttocks

        Scott,

        Do you believe if proponents of the ACA–from the grassroots through Congress and the White House–had simply refused to say anything whatsoever about it–no blog posts, no LTEs, no op-eds, no letters or e-mails to constituents, no press conference answers, no townhall meetings, no speeches, no appearances on tv or radio shows, etc. etc.–that public opinion on it would be the same today?

        • Scott Lemieux

          No. I’m not sure why the question is relevant, but no. As to the more relevant question of whether effective messaging could have persuaded public majorities to support the individual mandate,I think this is extraordinarily implausible.

    • For fuck’s sake, really?

      Alright, let’s hear your detailed and infallible plan for making the mandate popular such that it would have increased the bill’s odds of passing and being sustained by the unprincipled conservative SCOTUS majority. This is your one chance to get me to take this seriously for five minutes.

      • Incontinentia Buttocks

        I’m not drawing any conclusions about the effect of public opinion on the Court (which is an interesting question, but doesn’t concern what I said). My comment concerned the state of public opinion, full stop. And my contention was pretty simple: 1) the current state of public opinion is a contingent fact; 2) one of the things that created that state of public opinion was the messaging on the part of the ACA’s proponents and opponents.

        That’s all I’m saying.

        I certainly don’t think that any messaging plan (pro or con) would have been “infallible” (what is?), nor do I think I need to provide you with a detailed messaging plan to make the observation I made.

        It’s perfectly possible to observe that a political campaign is successful or unsuccessful without being able to reproduce or improve no that campaign yourself. I can see, for example, that Obama ran a brilliant primary campaign in 2008 and Hillary Clinton ran a less brilliant one without providing a detailed, infallible alternate course of action for Clinton.

        • You can “observe” it, yes, but if you want to continue pushing it as a sustained critique of Hillary Clinton’s campaign, then you kind of do need to actually come up with some better alternatives to merit being taken seriously, unless we’re just suppposed to accept as fact that there is necessarily some campaign strategy that would have ended in any candidate being nominated, and that there is no possibility that some candidates just never have a chance, or that external factors are irrelevant.

          In the same context, I don’t take it as any sort of given that there must be some “messaging strategy” that would make any provision of a bill popular with the masses, so to even begin taking your critique seriously at this point you really do need to have some sort of alternative to what the administration did, as far as I’m concerned. Otherwise it’s all just pointless bullshit, and you’re pushing to straight Mizner territory with the bald assumption you just made in reply to Scott above.

          • Incontinentia Buttocks

            Well, Brien, since it so pains you to take anything I say seriously and you are incapable of disagreeing with me without cursing and insulting me, kindly save yourself the trouble and ignore everything I say. I know that I won’t have much trouble returning the favor.

            You apparently think that only campaign consultants are in any position to criticize how campaigns are run. I disagree.

            I think politics is fluid and if the public misunderstands something, especially something about which they have been repeatedly lied to, that state of affairs needn’t have come about. That’s all I’m saying.

            • You don’t “think,” you “assume.” This is not a minor distinction. Your entire argument here rests on this assumption that public opinion is changeable by way of “messaging” in this regard. If you’re wrong about that, the rest of the house of cards comes tumbling down altogether.

              The problem is that you don’t even allow for the possibility that no form of “messaging” can change short term public opinion on, say, privatizing a portion of Social Security, and simply don’t engage the people who are operating under that assumption on these terms, ever. Which is why your constant evocations of “messaging” are just flat out tiresome and pointless. Your “observations” are a waste of time because those of us who are disagreeing with you simply don’t share your base assumption, so if you want to do more than beat that dead horse you actually do need to invest a little bit of energy in coming up with some sort of alternative theory that isn’t riddled with easily observable holes, otherwise the preponderance of evidence clearly suggests that you’re wrong.

              • Incontinentia Buttocks

                Brien, I allow for the possibility that messaging can have no impact on public opinion. I just disagree with it. (And when I say I disagree with it, among the insults that get thrown at me is that NOBODY believes this…see above.)

                I would take the claim that messaging has no impact on short-term public opinion more seriously if those who claim to believe this more affirmatively argued that the White House and Congressional leaders should stop wasting their time explaining legislation to the public and political campaigns should stop wasting money on advertising.

                But in fact, proponents of the view that messaging can have no impact on short-term public opinion never suggest that the hundreds of millions of dollars spent by our political system on such messaging has no impact. So it seems to me that they don’t actually believe what they claim to believe in these discussions.

                • “I would take the claim that messaging has no impact on short-term public opinion more seriously if those who claim to believe this more affirmatively argued that the White House and Congressional leaders should stop wasting their time explaining legislation to the public and political campaigns should stop wasting money on advertising.”

                  Well fine, because I’ll certainly argue that whatever time the White House spent on trying to come up with ways to move the needle on HCR polling in 2009 would have been a whole hell of a lot better spent on trying to figure out how to get economically stimulative provisions passed through Congress at every available turn.

                  “political campaigns should stop wasting money on advertising…”

                  I’m not sure how many times it has to be said that “getting people to vote for you over an opposing candidate” isn’t the same thing as “getting people to change their opinion on ‘an issue'”, but count this as one more time I guess.

                  Actually, in a way, this is self-refuting. The money Barack Obama spent campaigning in 2007 and 2008 made Barack Obama quite popular for an American politician in 2009, and that in turn did basically nothing to move the needle on the popularity of the healthcare reform package Barack Obama pushed and signed into law as President.

                • Incontinentia Buttocks

                  I’m not sure how many times it has to be said that “getting people to vote for you over an opposing candidate” isn’t the same thing as “getting people to change their opinion on ‘an issue’”, but count this as one more time I guess.

                  OK. Let’s talk apples-to-apples.

                  Do you believe that all advertising on ballot referenda is a waste of money?

                • Of course not, but your premise is rather complicated by the fact that most of that advertising, especially on the reactionary side of thins, isn’t exactly 100% honest, no?

                • Of course, it isn’t always effective either. How much of an effect did the money that went to defending Kasich’s anti-labor bills in Ohio have on voters? If there’s a conclusion to be drawn there, it’s probably that ballot advertising has a larger effect in instances where public knowledge and opinions are scarcer and less fully formed than in instances of high profile issues that get more attention and prompt a more defined hardening of public opinion.

                • Incontinentia Buttocks

                  So it seems we have substantial agreement on this! Messaging can have an effect, but does not always work. And being willing to be dishonest might improve the effectiveness of messaging (perhaps because it broadens the things one might say (?)).

                  Now please explain how you can conclude that proponents’ messaging on the ACA was necessarily optimally effective.

                • 1. Because healthcare reform clearly doesn’t fit the bill of being a low key issue people didn’t have strong opinions about.

                  2. Because the people who so fervently insist it can’t nevertheless have no actual ideas for how it could have been done.

            • david mizner

              He didn’t insult you, IB; he praised by saying you were heading into “Mizner territory.” Come on in! The water’s warm.

            • chris

              if the public misunderstands something, especially something about which they have been repeatedly lied to, that state of affairs needn’t have come about.

              OK, but in that situation, the side that didn’t do the lying doesn’t have the option of stopping the lying, so to say that *that side* could have changed the outcome is not necessarily correct.

              If the most effective strategy available to one side is less effective than the most effective strategy available to the other side, then the game is rigged and it doesn’t really make sense to critique the losers’ strategy. The other side could have thrown the game, but short of that, the outcome was foreordained.

              Of course this isn’t true *every* time, but it is true *some* times, so you have to actually look at evidence to determine whether or not it describes any particular case.

              • Also keep in mind that it’s just much easier to be in the opposition, because you just have to sit around thinking of good ways to oppose something and aren’t expected to come up with some sort of governing agenda, which makes it relatively easy to muddy the waters with bullshit. The “repeal and replace” mantra is a good idea of this, as the “mainstream” Republican “plan” basically was “Free ponies for everyone!”

    • david mizner

      I’ve asked this like four times and I always forget the answer: why does much of the reform — the mandate plus many of the subsidies designed to make health care affordable — not kick in until 2014? I think it set up that way to get a favorable CBO score (and therefore win the support of conservative Dems?) In any case, that strikes me a crucial problem; it’s hard for people to mourn something they don’t have.

      • Conservative Senator’s demands with regards to keep the bill’s cost below $1 trillion in the 10 year CBO window.

      • As I recall as well, this was regarded as not the most difficult concession because of the challenges of getting it up and running. I.e., part of the calculation was that a lot of this stuff wouldn’t be implementable much before then anyway.

        (Of course, I don’t know if they anticipated quite the insanity of some States in footdragging, cf FL.)

      • Scott Lemieux

        Yup, the biggest factor was apparently the arbitrary fiscal targets needed to get support from conservative Dems.

  • Alan Tomlinson

    The Magic Pony Plan, which most federal officials receive, is a primary reason why health care reform is such a son-of-a-bitch to institute. If all such officials were required to get their own insurance, things might move a touch, not a lot, but a touch, faster.

    Cheers,

    Alan Tomlinson
    (who couldn’t get insurance in the US if his life depended on it)

  • Steve LaBonne

    Has anyone checked the coin Kennedy uses to decide his votes? I’d hate to think it was lopsided.

    • Karate Bearfighter

      It has heads on both sides; this is why it is so important to correctly frame the issue before the Court.

  • CJColucci

    My prediction: Kennedy wavers, but decides he can’t declare most of the 20th century unconstitutional, Roberts then votes to uphold and assigns himself the 6-3 majority opinion to save the country from another incomprehensible Kennedy treatise. The Roberts opinion will artfully sow the seeds for later mischief.

    • Glenn

      Think you’ve nailed it.

    • Anonymous

      You’re fucking delusional. Roberts is on our side and he’s going to strike this law DOWN.

      • witless chum

        Wow, capital letters.

      • Murc

        So you’re saying Roberts is an idiot, then?

        I don’t dispute he’s on your side, but often, what an intelligent Chief Justice will do, if he’s going to be on the wrong side of a 5-4 divide is to make it 6-3 so he can assign the opinion to himself and water it down (or make possible the aforementioned future mischief) so as to do damage control.

        Now, it might not play out that way; Roberts certainly votes to strike the law if he’s the deciding vote. But if we can assume for a moment that’s not what happens, wouldn’t you WANT him to flip over and mess with the opinion? That seems like something you’d support.

        • NonyNony

          I actually expect that if it plays out like CJColucci describes above that there will be much wailing and gnashing and rending of garments but some in the right wing.

          Because Roberts is on “their team” and agreeing with Obama “helps the other team” and it’s all one big game of Resentment Football.

          Nevermind that it isn’t a game or that these are actually serious issues rather than “points” that can be “scored” one way or another. If “their guy” doesn’t move the football the way they want, they’re going to scream and cry just like they do when they’re backseat coaching from their recliners on Sunday.

          • joe from Lowell

            I actually expect that if it plays out like CJColucci describes above that there will be much wailing and gnashing and rending of garments but some in the right wing.

            And if that happens, the Village will then coo over John Roberts for “evolving.”

            • NonyNony

              Grod. My mind hadn’t even projected ahead to the media ass-kissing that will be inevitable in that situation.

              Thanks joe. Now I need a drink.

              • joe from Lowell

                “Why can’t President Obama be reasonable and accommodating like John Roberts? Why does everything has to be partisan warfare with him? John Roberts is willing to meet in the middle to get things done.”

                “Gee, Mr. Scarborough, that’s an excellent question. Even the liberal Washington Post agrees!”

      • joe from Lowell

        You’re fucking delusional.

        This is not a good way to begin a comment in which you misread something.

        If Anthony Kennedy wavers, as the allegedly-delusional CJCollucci said, then John Roberts doesn’t get to strike it DOWN.

        • CJColucci

          I actually am delusional, but that’s merely a contingent fact about me. My prediction stands on its own merits,or lack thereof, regardless of my generally delusional nature.

          • joe from Lowell

            You would think that.

            Because…you know…

    • ploeg

      This is what I expect to happen.

      Alternatively, if they ended up overturning the 20th century, within six years the burgeoning number of unemployed near-seniors without COBRA will compel Congress to lower the Medicare eligibility age nominally (age 62, say). And of course it will be unfunded and speed the collapse of the entire system.

      Hey, it makes about as much sense as any other possible outcome.

    • (the other) Davis

      If you’re feeling sufficiently confident about that outcome, you might consider trying to make a few bucks off of Intrade — it’s predicting about a 75% chance of SCOTUS striking down the Act right now. I’m tempted to do so myself, as I think prediction markets are pretty much worthless when it comes to forecasting the actions of nine people (actually just one, in this case).

  • c u n d gulag

    My guess is a 5-4 decision, along irrational/rational lines.

    They’ll say ok to the ACA, but not the mandate – to give maximum feckability to Obama and the Democrats in November, and help Mitt and the R’s win.

    This way, there’s no mandate, the ACA be basically unfunded, and yet it still gives Mitt and the R’s some raw, red meat to keep throwing to the base, promising that they’ll terminate it with extreme prejudice as soon as they swear their oath to God Almighty on The Bible on Inauguration Day – so help them God!

    As for the 77% of rational people – every one one of them knows that the system is completely broken.

    They know, because even if they DO get a raise at the end of the year, it’s immediately gobbled-up by a still greater increase in their employee contribution to the companies health care plan – and THAT’S for the people who ARE working, and HAVE employer-provided health care.

    Individual policies are virtually unaffordable to all but the wealthiest people and their families.

    The R’s will propose, besides ponies, unicorns, and free-markets:
    “Inter-state Insurance!”

    And the fight for “Inter-state” polices amongst states could be interesting.
    Which state will be the lowest common denominator for all of the others?

    Whichever state it is, the other 49 ought to rename it “Anarchy,” because it will immediately help to wipe-out any states minimum standards.

    Because let’s face it, when feckin’ Conservative idjits (but I repeat myself) talk about “State’s Rights,” what they mean is a state’s right to its own racism, misogyny, xenophobia, and homophobia.

    • I…don’t think this quite works that way, because without the mandate but with subsidies, you wouldn’t get families priced out of plans so much as the cost to employers and the government would explode. At the same time, insurance company profits would be decimated, and they’d bring a metric shit ton of pressure on the Republicans to fix the mess.

      • timb

        And, Scalia and Alito were both concerned about this prospect during oral arguments that they positively wept tears for the insurance companies….while staying completely composed at 30 million people without health insurance. Weird priorities

    • Anonymous

      You got it.

      Obama’s signature “accomplishment” will be struck the fuck down in the blink of an eye…

      • Cody

        Then millions more people will die without healthcare.

        Victory!

  • Anonymous

    What will happen? Liberals will whine, scream, bitch, moan, and rant.

    And it’s going to happen in juuuuust a few days–the Reagan Revolution rolls on!

    • c u n d gulag

      ZZZzzzzzzzzzzzzZZZZzzzzzzzzzzzzzzzzzz…

    • mpowell

      Yay people dying from lack of basic healthcare! It’s morning in American again!

  • mark f

    I hope [Alyssa Rosenberg] will look a little closer at Girls and its classism soon. I want art and criticism that speak to the entirety of the human condition, and until we get depictions of poor people in our popular media, I can’t have them.

    What McCarthyite circular firing squad purger wrote that, I wonder?

    • mark f

      Goddamn, isn’t this quite the non-sequitur now.

  • Anonymous

    After ObamaCare is struck down, Romney will get elected because of the godawful, weak, anemic economy, and he and the Tea Party Congress will proceed to dismantle what is left of the New Deal and the Great Society, and stuff the courts so full of conservative, strict constructionist, federalist society judges that they will have a majority for decades.

    And there’s nothing you can do about it.

    • BigHank53

      I’m sure you’re looking forward to living in North Haiti.

      • Cody

        I’m a bit more optimistic, it’ll be like West Haiti. There, you can see over the border to the D.R. and dream of what could’ve been.

  • DrDick

    My, my, my. Some unnamed creature in this thread is getting positively hysterical over this. Suggests to me that he/she/it is not nearly as confident about the outcome of this case or the general election as they pretend to be. Poor baby. I hope he/she/it has nightmares and keeps shitting the bed every night for the next 4-5 month.

    • Anonymous

      Did you see the Montana GOP convention, DrDick? I wonder what your dumbass, loud-mouthed governor thinks of THAT!

      • DrDick

        HIROTFLHAO, that is what. A sorrier insane clown show is hard to imagine. They are completely fucking pathetic.

    • rea

      And the curious thing is, for him, it’s all about political victory, not substantive policy. He never argues the merits of subtstantive policy. The fact that political victory for his side will be a disaster for the country is, from his point of view, a feature, not a bug.

      • Linnaeus

        It’s the taste of boot leather that keeps him going.

        • c u n d gulag

          And here I thought it was the taste of Koch Brothers asses, and the fine dingleberry picking there.

          • Linnaeus

            No reason it couldn’t be both.

      • Cheap Wino

        He never argues the merits of substantive policy because he doesn’t know what the hell he’s talking about. Do you think you could engage the merits if your news sources were Fox News and Michelle Malkin? Now imagine if you were kind of stupid and in that situation.

      • timb

        It’s how they all are. They’re nihilists. It’s why they cheer the former RINO who has supported everything they purport to oppose*, for driving his bus around campaign stops honking the horn, for heckling the President at events, and for Neil Munro’s interruption.** Because they believe in nothing, except partisan bs.

        *who signed into law this exact same bill, who supported gay marriage and “flip-flopped” on almost every issue

        **The irony of the Irish immigrant asking why the President supports “foreigners over Americans,” while performing a job an American reporter COULD do is lost on them. Maybe, they are just angry that CERTAIN immigrants get jobs?

      • NonyNony

        Alternatively he’s just a troll out to get people’s goats.

        That’s my suspicion anyway. You don’t need to know anything if your only purpose is to say something inflammatory to piss people off rather than engage in a discussion.

        For all we know “Anonymous” is a 12 year old social deviant who gets his kicks by trolling political blogs and laughing at people responding to him. Stranger things have happened. This is the Internet after all, where nobody can tell if you’re a person, a dog, or a spam virus that has accidentally gained sentience.

        • DrDick

          I would say a low functioning 12 year old hiding in the basement or attic coated in feces, but that is just me.

    • Manta1976

      I also don’t understand this celebrating *before* the (alleged) victory. My explanation is like yours: he is mightily afraid of defeat, and so he is trying score a few points while he still can.

  • Joe

    “you’re legally obligated to buy health insurance”

    This is a ‘message’ but it’s not actually the law. I would add “fwiw” since apparently not much.

    Anyway, an advocate was actually chosen by the USSC to argue that overturning the provision won’t collapse the house of cards. The justices weren’t really sold.

    One thing to remember is the teeth of the requirement only starts in a couple years. Starts. Some who are not covered will voluntarily get coverage from parents, subsidies, Medicaid expansion, pre-existing conditions needs, etc. A fraction will “game” the system. How many? A honest person says “who knows.”

    Meanwhile, after the elections are over, who knows if something could be passed to partially address the fraction in question. Rs in the face of some partisans are saying they will keep some of the measures. That in some states, local mandates will be passed. etc.

    The proof in the pudding involves looking down the road with the ’12 elections if anything even more important to determine what happens.

    • Cody

      I personally enjoy Republicans point out how much of a failure the bill is now. They point to still rising insurance costs, and proclaim ACA has failed!

      No one ever bothers to tell them it hasn’t taken affect yet…

      • Joe

        It has taken effect though … it purposely was set up so that everything wouldn’t happen at once. Wikipedia, e.g., has a pretty good listing of the various dates of operation here. The tax penalty is one of the things that did not take effect yet, nor did the requirement for contraceptive coverage for religious colleges.

  • Sebastian H

    Shorter thread above: messaging works, but only Republicans are capable of doing it….

    Now that we have that of the way how about this:

    We’ve repeatedly seen the assertion above that “The PPACA isn’t very popular. But this is somewhat misleading, in that the public supports most of the provisions of the bill but opposes the mandate, but the former are impossible without the latter.”

    Now assuming the last clause is true, which I’ll do only because I don’t want to argue about it right now, can we talk intensity here? Do people dislike the mandate *enough* that they would rather have no mandate and no PPACA? Do they like the other provisions of the bill *enough* that they would be ok with putting up with a mandate and having the PPACA? Do they like the other provisions *enough* that they would be ok with far more sensible laws (like making Medicare available to everyone at actuarial cost at time of signing up, with subsidies for poor people).

    This “doesn’t like X”, “does like Y” thing doesn’t mean anything without reference to intensity.

    • “Now assuming the last clause is true, which I’ll do only because I don’t want to argue about it right now, can we talk intensity here? Do people dislike the mandate *enough* that they would rather have no mandate and no PPACA? Do they like the other provisions of the bill *enough* that they would be ok with putting up with a mandate and having the PPACA? Do they like the other provisions *enough* that they would be ok with far more sensible laws (like making Medicare available to everyone at actuarial cost at time of signing up, with subsidies for poor people).”

      Most likely it’s neither, but rather another example of David Broder’s Magic Pony. People want the goodies without the mandate, and they simply won’t believe that the former is impossible without the latter.

      Think of it as a modified version of “I demand we eliminate the deficit without raising taxes or cutting Social Security, Medicare, or defense spending by eliminating foreign aid, cracking down on welfare fraud, and eliminating government waste, and if you tell me that that’s impossible you’re a dirty lying PARTISAN!!!!!!”

      • djw

        Right. Trying to figure out how people would think about tradeoffs (in a hypothetical world when people would actually accept that they have to make them) is simply something public opinion data can’t provide for us.

        • Scott Lemieux

          I’ll add that it’s entirely possible that a more sensible policy like single payer could well be more popular, but since it’s not a viable alternative to actually be enacted by Congress it’s beside the point.

          In terms of the analysis of public opinion, I think Brien and djw are right; the public doesn’t see the contradiction. (And, amazingly, you apparently don’t either.) It’s like Drew Westen saying that if you could use good “messaging” you could get the public to focus on their support for reducing unemployment rather than their support for reducing the deficit. The problem is that the typical voter doesn’t see this as a tradeoff.

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