Opinion: Waiting on the Supremes

Will you be singing “I don’t like Mondays” next week? You might, depending on how the Supreme Court comes down on the Affordable Care Act (ACA) and how closely its decision reflects your personal view of Obamacare. The smart money seems to be on an announcement coming on June 25, although it could come later in the week.

The key question is severability: if the individual mandate is struck down, can the ACA survive? That is “where the rubber hits the road,” says Paul Clement, former solicitor general under George Bush the elder and who led the Supreme Court case against the ACA. The issue that is being most closely watched by companies is whether the high court would agree to salvage the rest of the law even if it strikes down [the individual mandate] provision at the heart of it, writes Stephanie Kirchgaessner in the June 21 edition of the Financial Times.

But does it really matter in the grand scheme of things? Probably not, writes Leif Haase in the Atlantic. The Court’s decision may have a political impact, writes Haase, but “it is unlikely to make much of a difference to the future of healthcare reform.” The thesis is that healthcare reform is inevitable and will march implacably forward.

In fact, argues Haase, reform is already well entrenched and “Obamacare is as much a trailing indicator of where health reform is headed as its catalyst.” He notes that the healthcare industry has embraced change, employers are pushing reforms with new vigor and the structure of healthcare delivery is changing rapidly, regardless of the politics involved. “The main action taking place in health reform is on the ground,” writes Haase, as evidenced by the use of digital electronic records and “iPads and portable phones as low-cost medical devices.” Now there’s some change you can believe in.

I’m with Haase on this. The train has, indeed, left the station, and whatever the Supreme Court decides may be an important, but ultimately inconsequential, footnote in the future of healthcare reform.

So, regardless of the outcome, maybe you won’t have to harmonize with the Boomtown Rats come Monday . . . unless the stock market takes another nosedive, or the Euro zone inches a little closer to the edge, or the car won’t start. There’s always something.

—Norbert Sparrow