We've just witnessed a milestone in the history of the Supreme Court. For six hours over the course of three days, lawyers argued over the Patient Protection and Affordable Care Act, while protestors, thrill seekers and political candidates mingled on the steps outside. The court hasn't afforded a case this much of its precious time since it considered the Voting Rights Act back in 1966.
While this isn't Marbury v. Madison or even Brown v. Board of Education, it's certainly on par with a Roe v. Wade or a Bush v. Gore. Cases like these come along about once in a decade, and some—like this one—help define us as a democracy still struggling with growing pains. And come June, we'll find out how this one turned out and move on from there.
(And, yes, we will move on no matter how this turns out.)
We've gone over the wealth of options the court has at its disposal, but one outcome in particular emerges as a doomsday scenario, and while it's as unlikely as it would be devastating, there remains the possibility that the court will throw out the mandate while keeping the rest of the legislation intact.
Of course, we all know how bad this would be, but I'm not altogether sure the mainstream media—and by extension the voting public—have a clue. And between you and me, the latest estimates predicting anywhere from 10 percent to 30 percent premium jumps are conservative at best.
In a nutshell, people hate the mandate, but love the very things that make it necessary, such as raising the age of dependent coverage and doing away with pre-existing condition clauses for carriers. A recent Kaiser study pointed to this, revealing roughly 52 percent of Americans expected the court to throw out the mandate—as if it were some minor annoyance and not the lynchpin of the entire 1,200-page law.
And this speaks to only one facet of the general public's ignorance when it comes to the entire health insurance business. It boils down to what insurance is, at its most basic, and that's something we all take for granted on a daily basis.
“You get 10 people to put $100 in a pool on the first of the month and that's what you have to spend on medical care that month—for all 10 people. After that's gone, you have to wait until next month.”
This is what a frustrated broker told me last week. He couldn't understand why some carrier with a huge marketing budget couldn't put out an educational video or even a campaign-style ad to remind everyone what insurance is. The resources are finite—whether we're talking about the pool of funds or the number of service providers—so why do we as consumers expect infinite care?
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