We’re more than halfway through Barack Obama’s second term as president and many things that might have been feared about his agenda haven’t come to pass.
He hasn’t had the Bill of Rights translated into Esperanto. He hasn’t declared soccer our national pastime. And he hasn’t, God forbid, tried to convert us all to the metric system.
But Obama did succeed in signing into law the Patient Protection and Affordable Care Act. And ever since, his Republican opponents have been warning that the law they call Obamacare would kill jobs, as well as women and children.
Congressional votes to repeal Obamacare have become routine. And even if such a measure were to get through, the president would surely veto it. Expect those votes to continue after Obama is out of office.
Expect too, more legal challenges. On Thursday, the U.S. Supreme Court upheld the law for the second time, deciding that an ineptly worded passage shouldn’t be used to keep people in states that use the federal exchange as their health insurance marketplace from getting the premium subsidies that make their coverage truly affordable.
So, is Obamacare here to stay, as the president says?
A Republican president who supports repeal could be elected in 2016. And there’s no predicting what inventive lawsuits might be filed.
But with every year, Obamacare becomes more entrenched, and repealing and replacing it becomes tougher.
Consider the numbers: More than 6 million people signed up for Obamacare plans for 2014. That doubled to 12 million this year. The Congressional Budget Office projected enrollment to reach 21 million next year and 24 million to 25 million by 2017. Most people receive subsidies. A lot of them would be upset if that benefit were touched.
Hospitals have come to expect that fewer of their patients arrive uninsured. Truman Medical Center alone estimates the law has cut its uncompensated care burden by $5 million to $6 million.
Former Missouri insurance commissioner Jay Angoff recently called these new enrollments a “bonanza” for the insurance industry, which is a politically powerful group.
“Insurance companies have made huge changes in how they do business,” said Linda Sheppard, an analyst with the Kansas Health Institute. With Obamacare, insurers no longer can deny coverage because of a medical condition, for example, or charge women more than men.
“When you have so much implemented, how do you undo it, and at what cost?” Sheppard asks. “It’s not like you can go backward from that.”