For years, the Affordable Care Acts crises have lent themselves to binary outcomes. The law would pass, or it would fail. It would be upheld by the Supreme Court, or it would be struck down as unconstitutional. Barack Obama would win reelection, or Obamacare would be hollowed out by Mitt Romney. Over and over again, the choice was (or at least seemed) stark: Life or death. Thats because the law was, for most of the last three years, a political abstraction, and the fight was over whether it would survive long enough to be implemented. That ended on October 1st. The pundits tendency to view the long-term fate of the law as a success or failure is a symptom of short-term political thinking. writes Austin Frakt. HealthCare.govs troubles are real and severe. But for the law, the possible outcomes arent life or death, or even success or failure. Theyre vastly broader than that. The law could limp through its first six months of life but see enrollment surge as people face the choice of handing over one percent of their income or purchasing insurance. Thats basically what happened in Massachusetts. The law could succeed wildly in some states while failing in others. Its easy to imagine a world in which Californias all-out effort on behalf of the law and Texass all-out obstruction lead to California having a best-in-class, near-universal health-care system while Texass health-care system collapses into even more of a mess than it already is. The law could fail relative to expectations and prove a political disaster for Democrats, but still be delivering insurance to more than 10 million Americans come 2017. As a result, President Chris Christie could find himself with a mandate to make changes but no earthly way to pass full repeal. Obamacare thus becomes the platform for a far-reaching set of Republican health-care reforms. The permutations are countless -- with two exception. The law wont work perfectly and record 100 percent approval ratings anytime in the next few years. And nor will it be repealed. Unanimously recognized success and actual failure are virtually the only two unthinkable outcomes.
Posted on: Mon, 28 Oct 2013 13:20:11 +0000
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