This month, the Supreme Court may well deliver a fatal blow to ObamaCare in King vs. Burwell, by ruling that the health insurance subsidies handed out through federal exchanges in 36 states are illegal. Many liberals seem to think that the only thing preventing the president's crowning domestic achievement from becoming a rip-roaring success is this largely specious and semantic lawsuit. But here's the thing: ObamaCare is teetering due to its own internal contradictions that have nothing to do with the lawsuit.
ObamaCare's supporters would like everyone to believe that with Healthcare.gov now functioning, everything is just fine and dandy. Contrary to what the conservative press (which I guess would include me) has been saying about the many problems of ObamaCare, Vox's Ezra Klein declared last September that "in the real world, it's working." In February, his fellow Voxland inhabitant Sarah Kliff rattled off eight ways in which the law had proved its critics wrong.
But has it? Not really.
For starters, the exchanges have enrolled about 3 million fewer people than the Congressional Budget Office projected in 2010. And far fewer of the enrollees are from the ranks of the uninsured than hoped. Medicaid enrollment is lower too, for the simple reason that states refused to expand the program.
The core of President Obama's sales pitch to America was that the program, which he called the Affordable Care Act, would "bend the health care cost curve" and save an average family $2,500 on their premiums each year. How would it accomplish this feat? Essentially, he said, by forcing uninsured "free loaders" who show up in the emergency room to obtain free care to either buy (subsidized) coverage on the insurance exchange or sign up for the expanded Medicaid program. The point was that if they had coverage, they'd get cheaper care sooner in a doctor's office rather than more expensive care later in a hospital emergency room.
