On Thursday, the U.S. Supreme Court, in a 6-3 ruling in the case King v. Burwell, decided to venture from more than 225 years of our republic’s history to allow something expressly forbidden in the Constitution of the United States – the ability of the executive branch to change the actual text of legislation to suit its political wishes. The repercussions of the ruling will be felt for generations, and thus we would predict that administrations both Republican and Democrat will cite King v. Burwell whenever the text of a law – whether on government surveillance, banking and financial regulation, even tax law – does not say what the administration wants it to say.
With this ruling, legal challenges to the constitutionality and legislative intent of Obamacare have been, for all intents and purposes, exhausted. Congress passed the legislation, the President signed the legislation, and subsequently the electorate had an opportunity to vote in 2012.
Those of us who believe that the Constitution’s provisions should be taken strictly as they were written by the framers disagree with the Court’s decision. But the Court has ruled. Individuals who purchase health insurance on the federal Obamacare exchange will be granted taxpayer subsidies that artificially mask the real cost of health insurance. Regardless of whether a state set up its own exchange or relied on the federal exchange, subsidies will flow.
It is widely reported that as the rollout of Obamacare continues, costs will continue to rise and place an even greater strain on individuals, insurers, and a federal government already drowning in debt. Insurance providers across the United States are forecasting double-digit premium increases for 2016, the year the employer mandate kicks in. In Florida, proposed rate increases are as high as 60 percent for certain plans. In Texas, rate increases of more than 30 percent will be common.
So, what now?
The first thing is to resist the very understandable urge to panic. We now know the field, and it’s time for a game plan. It would be extraordinarily unwise to abandon the push for free-market reforms in healthcare delivery. Those of us who understand and champion the value of free markets have argued that the healthcare system has three main desired outcomes – maximum access to care, highest quality of care, and lowest cost of care.
There exist specific reforms that Congress and state legislatures can and should enact that would serve to restore sanity and place our healthcare insurance system back on a sustainable track.