So, now that the Democrats can either crow that they got their landmark legislative accomplishment passed, or cry because they'll be losing their jobs come November, what's next?
Here's a few guesses. First, huge parts of this law are going to get gutted by the courts before most of it goes into effect.
There are probably three things that will be subjected to a lot of legal challenges.
1) The Individual Mandate. This will probably get thousands of individual court challenges, in every district of the Federal system. That's going to make it the funnest part of the whole thing. The 9th is going to find some reason that it's constitutional, the 4th is going to laugh and put a stay on enforcement, and DC is going to spin like a top trying to figure out what to do.
My guess is that it will be fast tracked and in the next 18 months end up in Robert's hands at the Supreme Court, where it will die a 5-4 death.
That decision, though, will doom private insurance. The mandate is the only reason they are behind this bill. Without it there is no chance they can make money with the other insurance restrictions on the bill.
2) Individual "Sweetheart deals" that some states got to get votes. While the reconciliation bill killed the Cornhusker Kickback, Louisiana is still getting $100 billion to 300 billion in extra cash, Florida seniors keep Medicare Advantage while everyone else loses it, one town in Montana gets it's Medicare paid for.
Many state AG's threatened to sue over those provisions in December when the Senate passed the bill. Expect it to happen shortly after the signing. The Florida medicare advantage clause may well be the one that dooms a bunch of the bill.
3)While many states are going to scream about the hundreds of billions in unfunded mandates, they don't have much standing to do anything about the bill. Unfortunately for them (and us) the courts have upheld the federal government's ability to pass costs to the states many times.
My guess is that at least one state will be able to say the new Medicaid costs will bankrupt them, and threaten to file a Chapter 9 petition for bankruptcy unless the Feds pick up more of the cost. By the way, Illinois, my state, would be a perfect fit. Unfortunately, our lackeys in Springfield think this is a good idea.
Labels: Constitution, Courts, Health Care Reform, ObamaCare