Here’s a quick checklist of the 10 worst things that will be left in the law if the Supreme Court voids only the individual and Medicaid mandates:
1. Employer mandate: Most companies will have to provide and pay for expensive government-determined health insurance for their employees or face federal fines.
2. Conscience mandate: Religious organizations will still be required to provide free sterilization, contraceptives and abortion-inducing drugs to their employees, even if this violates their religious beliefs.
3. New and higher taxes: The law contains at least 20 new taxes totaling $500 billionthat will hit medical innovators, health insurance and even the sale of your home.
4. The Independent Payment Advisory Board: This unconstitutional board, with its rationing power over Medicare, will stand.
5. State exchanges: States will be compelled to set up vast new bureaucracies to check into our finances so they can hand out generous taxpayer subsidies for health insurance to families earning up to $90,000 a year.
6. Medicare payment cuts: $575 billion in payment reductions to Medicare providers and Medicare Advantage plans will cause more and more physicians to stop seeing Medicare patients, exacerbating access problems.
7. Higher health costs: The Kaiser Family Foundation says the average price of a family policy has risen by $2,200 during the Obama administration. The president promised premiums would be $2,500 lower. Hospitals, doctors, businesses and consumers all expect health costs to rise under the law.
8. Government control over doctor decisions: Value-based payments, quality reporting requirements and government comparative-effectiveness boards will dictate how doctors practice medicine. Nearly half of all physicians are seriously considering leaving practice, precipitating a doctor shortage.
9. Huge deficits: The Congressional Budget Office has raised its cost estimate for the law to $1.76 trillion over 10 years, but that is only the opening bid as more and more people will lose their job-based coverage and flood into taxpayer-subsidized insurance.
10. More than 150 new boards, agencies and programs: The Obama administration will work quickly to set up the law’s new bureaucracies to lock in government control of the health sector.
Posted on The New York Times: Room for Debate, June 18, 2012.