Don't Tell the GOP, but It's Already Too Late to Kill Healthcare Reform

The recent decision by a Virginia federal judge declaring the healthcare reform law unconstitutional has gotten a lot of media attention -- far more, in fact, than the two previous federal court rulings in favor of the statute. Despite the uncertainty created by the decision of U.S. District Judge Henry Hudson, the Affordable Care Act has a stronger chance of survival than many observers seem to think.

One piece of evidence is that only two states -- Minnesota and Alaska -- have turned down $1 million federal grants to plan the health insurance exchanges that are slated to start up in 2014. Grant recipients include most of the 20-plus states that are now suing the federal government to overturn the individual mandate to purchase insurance. So even those states must figure there's a good chance that the exchanges will open for business on schedule.

(It's no coincidence, BTW, that Minnesota turned down the grant, because Minn. Gov. Tim Pawlenty, a Republican, is expected to run for President in 2012. It's hard to say whether Sarah Palin's apparent lust for the White House affected Alaska's decision, since she's no longer governor of that state.)

More evidence that Republicans won't find the ACA a pushover is found in a recent article by conservative pundit Joseph Antos. A fellow of the American Enterprise Institute, Antos opposes the reform law as much as any Tea Partier does. Yet he doesn't think Republicans will be able to do much to stop it in the next two years. Here are a few of his predictions for the 112^th Congress:

• The Affordable Care Act will not be repealed.
• Major provisions of the law will not be altered.
• The Senate will refuse to cut off funds authorized to implement reform.
• But no further funds will be appropriated for reform-related activities.

The ACA's big advantage is that, like any other big federal program, it will gather momentum as its constituent parts come together. Even Antos admits this: "Despite the talk of repeal, Congress will not pass any major health legislation over the next 2 years, and the health sector and private employers will be hard at work preparing for 2014, when many ACA provisions take effect."

What this means is that even a Republican president -- should one be elected in 2012 -- may have a hard time derailing the reform train, which will be developing a head of steam around then. Reform might be delayed or revised, but not repealed.

The same dynamic could also apply to the U.S. Supreme Court, which has a history of responding to social change. If a majority of the people support reform by the time the High Court looks at the ACA's constitutionality, it's possible that a majority of the Justices might uphold it rather than overturn a statute that so many people regard favorably. And they'll have to think twice before they reject something that the government believes it needs for its long-term fiscal health.

None of this means that a President Palin or the Supreme Court couldn't drive a stake into the heart of reform. But for healthcare industryites looking ahead, it makes sense to assume that the ACA will be implemented, more or less as written.

Image supplied courtesy of klearchosguidetothegalaxy@blogspot.com.
Related:

• Pawlenty as President Could Make "Repeal and Replace" Respectable
• Psst! Business Actually Sees a Lot to Like in Healthcare Reform
• Some States Now Want to Abandon Medicaid--And With It, Healthcare Reform
• Healthcare Reform: Wyden-Brown Bill Is a Trojan Horse