A conservative defense of the Obamacare ruling and what’s next
So Tea Partiers are going to drop their own health coverage just to spite President Obama? Really?
The truth is, most of the conservatives most exercised over the decision need to get a life. In fact, the court’s ruling should be considered an occasion for good conservative policy-making. As a result of the court’s decision, serious, reasoned debate over the plan’s many bad parts and few good ones can now move to Congress.
Quite simply, the ruling makes sense from a conservative, limited government point of view. Given that reasonable, thoughtful people clearly had very different views about the law’s underlying constitutionality, it’s entirely proper that the court deferred to Congress. The grounds on which Chief Justice John Roberts wrote the court’s majority opinion — taxing power rather than the Commerce Clause — may actually serve to limit Congress’ ability to use the Commerce Clause to expand the reach of government in the future.
Of course, none of this is to say that Obamacare itself has much to recommend it from a conservative point of view. All in all, it’s too big, too expensive, too dependent on regulations, too mistrustful of markets and too disrespectful of Americans’ religious faith. It will place so many people in healthcare systems that are government-run or government-subsidized that it will create a much larger constituency for big government. Several parts of it, including a long-term care provision that the Obama administration has already discarded, are also poorly drafted by any objective standard. But the mere fact that a policy is bad doesn’t make it unconstitutional.
Despite lots of talk about “repeal and replace,” the Republican House of Representatives’ only significant healthcare achievement has been a one-page bill that repeals the Affordable Care Act outright. This makes for good theater, but it’s impractical, since parts of the law that increase senior citizens’ drug benefits and let adult children stay on their parents’ health insurance plans are already in place and repealing them would cause mass anger.
Except for Rep. Paul Ryan, R-Wis. — who, along with Sen. Ron Wyden, D-Ore., proposed a smart, workable “Ryden” Medicare reform plan — few good ideas have arisen from the Republican Caucus. Those ideas that have significant support amongst Republicans, such as allowing for the purchase of health insurance across state lines, have significant practical implementation-related problems that existing legislative proposals don’t address. At least part of the reason for this relative intellectual wasteland amongst Republicans in Congress is the simple hope that the Supreme Court would do the GOP’s work for it and relieve members of the hard work of crafting their own plan.
Now, that isn’t going to happen. And instead, Republicans are going to need to offer their own free-market answers to the genuine problems that President Obama and the Democrats sought to address. The “Ryden” plan, which would give senior citizens “premium support” vouchers as an alternative to Medicare, has a lot to recommend itself as a model. Rather than trying, largely unsuccessfully, to repair an already seriously troubled healthcare system or, worse yet, pretending that the health care status quo is workable, Republicans might do well to use this plan as a model and replace almost all existing healthcare subsidies with a simple, predictable program tied to recipients’ income and age. The subsidies might cover almost all costs for poor children and lower-income senior citizens, while offering modest help to most families and nothing at all to the truly well-off.
Whatever happens, the court made the right decision. Now, Republicans in Congress must do the real, hard work of using free-market principles to build a better healthcare system.