Mr. President, the centerpiece of your domestic agenda, the health care overhaul that bears your name, has just been declared unconstitutional. I celebrate this victory for freedom and for limited government, and I invite you to consider the opportunity it offers you.
To be precise, it was the individual mandate to purchase insurance that was determined to exceed the letter and spirit of the Constitution. But this ruling threatens the entire edifice of Obamacare because that mandate is the central linchpin of the Affordable Care Act. In the simplest of terms, the goodies Obamacare promises depend on the money brought in by compelling young, healthy Americans to purchase more insurance than they need. It’s a clever version of redistribution, but it’s not immune from this one simple reality: no money, no goodies.
In light of this week’s ruling and in the peculiar absence of a severability clause in your law, the courts may find legal reason to strike down the entirety of Obamacare. (After all, would Congress still have passed this massive overhaul if it didn’t have the mandate? Recall that it did so only with a razor-thin, single-vote margin. Dare to have the Congressional Budget Office re-score Obamacare now without the mandate?) But even if the courts don’t strike down the whole law for legal reasons, it should be stricken for logistical ones. Obamacare just won’t work without the mandate.
To your credit, just last week, the White House acknowledged in no uncertain terms the impending collapse of Obamacare absent the individual mandate.
If the constitutional challenge to the Affordable Care Act’s individual-responsibility requirement ultimately prevails, it would mean that provisions preventing health insurance companies from discriminating against people with pre-existing conditions also would be invalidated by the court because the two are inseparably linked. If insurance companies are required to cover those with pre-existing conditions, who are potentially more expensive to cover, without requiring everyone - both sick and healthy people - to have insurance, premiums will increase rapidly. Similarly, other provisions - including banning insurers from discriminating based on health status, age and gender - also will fall.
Of course, these seismic foundational cracks in Obamacare could not have come at a worse time for you. Last month, you took a historic shellacking, and last week, for inexplicable reasons, you created the horribly awkward visual of surrendering the presidency to Bill Clinton, if only temporarily. This was made even more puzzling considering that Mr. Clinton’s purpose was to persuade Democrats to keep President George W. Bush’s tax rates intact rather than allow them to revert to his own - theater of the bizarre. Let me guess, that press conference was his idea, but he made you think it was yours, didn’t he? Slick.
Now your presidency is spiraling out of control. Your poll numbers are dropping like the temperature at a global-warming conference. Your own party can’t discuss you without dropping the f-bomb. Your allies are forced to squelch rumors of primary challenges. Intrade Prediction Markets has even begun selling futures on whether or not you can reach the finish line of your first term.
Just as devastating, likely voters favor repeal of Obamacare almost 2-1. In truth, your allies in Congress let you down by forging such a disastrous plan. I imagine you were just as shocked as I was to learn that the Obamacare “author,” Sen. Max Baucus, Montana Democrat, admitted that even he hadn’t read the bill. America deserved better than a plan that will bankrupt insurance companies and drive doctors out of practice.
But here’s your chance to turn this ship around. You must realize that it won’t be achieved with small, timid moves. Be bold. Lead the charge to repeal Obamacare. I know this is against every instinct you have, but look where your instincts have gotten you. This is your chance to hit that reset button.
Can you make this pivot? You spent years claiming the Bush tax cuts were only for the rich and were the root of all evil, and now you’re their biggest cheerleader. Yes, you can make this pivot - and for good reason. The truth is, America has the finest health care delivery system in the world. It certainly needs reforms, and I will pledge myself in your service to achieve them.
You were wise to recognize the conservative ascendency in your recent tax-cut deal with the Republicans. Had you not dealt when you did, your terms only would have become worse. The same calculus applies to health care reform. Consider your alternatives. Dig in over the next two years and stake your legacy on Mr. Baucus’ crumbling and deeply flawed plan, and then, assuming it survives the courts, witness from the sidelines as a new president and a new Congress dismantle it. Or be bold and join those of us who champion free-market reforms and will honor the American principle of helping all those who cannot help themselves.
Mr. President, if you seek health insurance for all Americans, health insurance companies must survive. If you seek medical care for all citizens, doctors must keep their practices. If you seek prosperity, if you champion freedom, Mr. President, tear down this law.
Dr. Milton R. Wolf is a radiologist and a cousin of President Obama’s. He blogs at miltonwolf.com.
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