In the latest episode of the Roosevelt Institute’s weekly Bloggingheads series, “Fireside Chats,” Senior Fellow Mark Schmitt talks to Scott Lemieux of Lawyers, Guns, and Money and The American Prospect about the machinations behind the Supreme Court’s recent health care ruling and what challenges lie ahead for the Affordable Care Act. Mark notes that while Republicans have tried to spin the ruling by claiming that they can use reconciliation to repeal the individual mandate if it’s a tax, the truth is that they always could have but never will. Echoing his recent post on this subject, he maintains that they have “less than no reason” to repeal the individual mandate as long as insurance companies are lining their pockets.
Mark thinks the recent revelation of Aetna’s $7 million donation to conservative groups is significant given that “overall the health insurance industry basically has staked out with the Republican Party,” but insurers were forced to work with Democrats during the health care reform negotiations to get a seat at the table. He explains that the conflict for insurers has always been that “they would love to have as many customers as possible, so if you create a mandate, that’s a great thing for them,” but it also means that they’ll have to put up with more regulation as part of an overall reform package. “If it was all regulation, no mandate, they wouldn’t want it; if it was all mandate, no regulation, they’d love it; and then there’s two acceptable positions. One is the status quo… pre-2010, and then ACA they were basically fine with.”
Now that the Supreme Court has upheld the law, Mark notes that the worst outcome for insurers would be that “only the mandate gets struck,” since they would get all of the new regulations and none of the new customers. He says that “now that these companies are fully back at the table with Republicans, the Republicans simply are not going to just repeal the mandate. It’s just not an option they have with their cash constituents.” As for repealing the entire law, he notes that there is plenty of internal division among Republicans about preserving the more popular provisions, like guaranteed issue and the ability for young adults to stay on their parents’ insurance plan until age 26. “I think they’re really stuck, and I think we should really just draw the line and say, ‘Here it is, we have the Affordable Care Act. It’s not going anywhere, nobody’s repealing it, now it’s time to make it work.'”
For much more, including Mark and Scott’s take on how the Supreme Court reached its surprising verdict and why it’s been leaking like a sieve ever since, watch the full video below: