The Supreme Court’s odious ruling on the Medicaid expansion in NFIB v. Sebelius has had awful direct effects, leading to millions of people being denied health care. But, as Alec Macgillis notes, it’s also had important political consequences:
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this year is more Obamacare, not less.
Let me explain. For starters, Democratic pollsters who surveyed the Florida district, number 13, on the Gulf Coast around St. Petersburg, say that the Affordable Care Act was not a drag on Democratic candidate Alex Sink, that in fact survey respondents said they trusted Sink more than Republican David Jolly to handle Obamacare.* Sink’s candidacy had other problems—her image as an outsider who’d moved to the district just to run to the race, her generally over-cautious and un-dynamic manner, President Obama’s low approval ratings amid a slow economic recovery and, yes, the quadrennial Democratic problem of getting voters to turn out for non-presidential elections. As NBC’s First Read reports: “Turnout last night was 183,634. However, in the 2012 general election—when Obama narrowly carried the district—turnout was nearly double at 329,347. And even in the 2010 election, turnout in that district was 266,934.”
So how to get more Democratic voters out? Well, this is where the more Obamacare comes in. To the extent that the new law has not created a groundswell of enthusiasm for Democratic candidates among the law’s intended beneficiaries it is surely in part because…so many of the law’s intended beneficiaries are not being helped by the law. Fully one half of the expansion of health coverage under the law was supposed to occur through the expansion of Medicaid, to cover all people under 138 percent of the poverty line. And in Florida and nearly two dozen other states, that expansion is not happening, thanks to the Supreme Court ruling that made the expansion optional and the opposition of Republican governors and state legislators.
As Balkin and Levinson observed, one of the many outrageous things about Bush v. Gore was that by lawlessly helping to install and legitimize their preferred presidential candidate the Gang of 5 helped advanced their constitutional views on many other issues as well. Similarly, by inflicting serious damage to the ACA the Roberts Court did a major solid for the Republican Party as well as causing lots of needless suffering. Which one could perhaps live with if it was justified by the clear language of the Constitution or even clearly compelled by precedent, but not even close on either count.