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So what happens if the health care overhaul is overturned?

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Health Care Fallout

After last week’s Supreme Court arguments over the Affordable Care Act, President Obama’s signature achievement seemed doomed. Noted court watcher Jeffrey Toobin saw it as a train wreck and a plane wreck. Yeah, that bad.

So if it’s overturned, what’s the fallout? Americans have a complicated relationship with the law — opinion polls show irrationality and confusion. People don’t like it in general, but when asked about specifics, they change their minds. For example, a new CBS/New York Times poll finds that only a quarter of the public wants to keep the law as-is, yet 85 percent like preventing insurance companies from denying coverage over pre-existing conditions.

So in the days after the law is hypothetically killed, if people are told their husband’s bout with cancer means finding insurance is impossible (like it used to be), the blowback from that 85 percent could be ugly. This might be where Washington AG and gubernatorial candidate Rob McKenna finds himself if the you-know-what hits the fan. McKenna challenged health care reform on behalf of all Washingtonians.

Keeping the Issue Alive

If the health care overhaul is not overturned, Republicans could continue to rail against it (although that’s tough for Mitt Romney, who was for affordable care before he was against it). And isn’t that really what the GOP wants? An election-year bludgeon?

Meanwhile, Obama’s best re-election strategy could emerge from the ruins — to pitch himself as the only man standing in the way of more justices like Clarence Thomas and Antonin Scalia.

Irony Alert

The long term is tougher to predict. America’s health care system is broken, and the ACA tried to get some solutions into the pipeline. To oppose that with no credible replacement policy is a kind of political nihilism. If repealed, years of ensuing national pain and expense will reveal that short-term political gain trumped the health and wealth of a nation.

Ruling against ACA would box in legislators and, ironically, put the private insurance industry on the endangered species list. Without the mandate, the only legal option left to Congress will be Medicare-for-all. The Supreme Court may, in effect, endorse the kind of big-government solution conservatives hate.

Without reform, future Congresses will find themselves presiding over a nation drowning in health care bills. American businesses will struggle to compete; they may start bailing out of providing insurance. Something will have to give, and Medicare-for-all will start sounding pretty good. Change won’t come in a year, or even a decade, but if ACA is overturned, single-payer will come.

Don’t bet on the death of Obamacare.

— TED S. McGREGOR JR, @INLANDERTMX

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