When it’s wrong it must be right.
That oxymoron embodies the six-year history of Obamacare. Everything from the law’s formal title, to the court rulings upholding parts of it and striking down others, is tainted by something more disturbing than the plague of partisan animosity. If language was essential to the story of human progress, then the abuse of it here and elsewhere may be taking us in the other direction.
Rep. Craig Johnson, R-Anchorage, is sure he’s right. That’s why he filed an appeal to the Alaska Supreme Court in the case challenging Gov. Bill Walker’s decision to expand Medicaid. The Legislature’s Division of Legal and Research Services was of the opinion he needed a vote by the full House to proceed with the appeal. Johnson, who isn’t a lawyer, simply says the lawyers are wrong, just like the Legislative Council did when they first filed the lawsuit. Which, by the way, they lost.
Then there’s the claim by the majority in both houses that they oppose Medicaid expansion. But when asked why they won’t just hold a vote and reject it, many admit that enough of the majority would vote in favor of it. Thus, on this issue the majority isn’t in the majority.
At the national level, House Republicans got a favorable court decision in their long-running effort to dismantle Obamacare. A federal judge ruled the Obama administration had improperly funded a significant subsidy authorized by the law. But that complaint wasn’t anywhere on the Republican radar. They were focused on Obama’s decision to unilaterally delay implementation of the individual mandate, which, in another irony, was the main object of their disgust with the law. They were wrong on that count but it turned out right for them because of something they didn’t even think was wrong.
The individual mandate had already been upheld by the Supreme Court four years earlier. It didn’t matter that the Obama administration argued it didn’t violate the Constitution’s Commerce Clause and that people would be penalized, not taxed, for failure to follow the law. The Court ruled the mandate violated the Commerce Clause but was allowed by the government’s taxing authority. So Obama won even though he lost both arguments.
But the ruling also states “The Affordable Care Act does not require that the penalty for failing to comply with the individual mandate be treated as a tax for purposes of the Anti-Injunction Act.” So the mandate is constitutional because Congress can tax us even if they aren’t imposing a tax on anyone.
Beyond the lawsuits is the problem with the insurance marketplace. This month, Moda Health announced it won’t offer health insurance for individuals in Alaska next year. Sen. Lisa Murkowski, R-Alaska, immediately blamed Obamacare for “driving insurers off the exchanges and out of business, reducing the competition in the marketplace and further driving up costs for consumers.
I agree that the law isn’t working in Alaska. But the system wasn’t working before it either. Premera Blue Cross and Aetna had 95 percent of the market share in this state. That minimal competition wasn’t unique. Nationwide, a series of mergers, which began 15 years before Obamacare, had reduced the industry to just five dominant companies. And now two more possible mergers may leave just three.
Unregulated capitalism is supposed to breed competition. That’s good for consumers. But in terms of profit, it’s bad for the businesses competing with each other. That’s why, even without regulation, the system devours its offspring.
The problem with Obamacare is it never could make heath care affordable for everyone because it expected health care insurance businesses to solve a problem they helped create. But our worship of capitalist freedom makes it politically incorrect to blame the private sector for any of society’s failings. So we’ve gotten into the habit of creating present political realities by imagining the reality of the past never happened.
“It is what it is,” we like to say. But our language tries to make things what they aren’t. The Obamacare Health Insurance Exchange Marketplace is neither a market nor a place in traditional terms. We’re all health care consumers even though no true consumption occurs. And the Patient Protection and Affordable Care Act is about how medical bills get paid, not medical treatment or the cost charged by doctors and hospitals as implied by the title.
Long ago we began flirting with this doublespeak from George Orwell’s world. Garbage dumps were renamed sanitary landfills. Life insurance has never guaranteed we’ll live beyond tomorrow. National security describes our collective insecurity; we’ve gone to war to preserve the peace.
Masking our problems this way can only create more problems than we make believe we’re solving.
