Three years later, people are still trying to figure out what Obamacare says. Last week, newspapers reported that because the employer mandate fails to specify the “minimum essential coverage” employers must offer, firms can satisfy the mandate by offering “skinny” benefits that cover hardly anything. Thus a government guarantee of comprehensive coverage could instead encourage employers to offer less‐comprehensive coverage. Since Obamacare’s provisions are all connected, this glitch could send premiums and government spending even higher.
But the main reason Obamacare is encountering obstacles is simple: the American people do not want it. Recent polls show 54 percent of Americans oppose the law, 53 percent want opponents to “continue trying to change or stop it,” and 56 percent want to return what we had before. This June will mark four solid years of public opposition. Some polls show a mere third of the public supports Obamacare. Unions that supported it are now “frustrated and angry” over its unintended consequences. One such union is calling for repeal.
When a minority encounters obstacles to imposing its will on the majority, we call that “democracy.”
Indeed, democratic accountability forced Obamacare’s authors to give states veto power over many of the law’s provisions, and is leading states to exercise those vetoes. Two‐thirds of states have refused to implement Obamacare’s health insurance “exchanges,” a move that blocks some $800 billion of new entitlement spending. Thanks to last year’s Supreme Court ruling, as many as half the states may likewise veto Obamacare’s Medicaid expansion.
Yet the I.R.S. is preparing to tax, borrow and spend that $800 billion anyway, and the Department of Health and Human Services continues to coerce states into implementing portions of the Medicaid expansion that the Supreme Court rendered optional.
Obamacare may be the law of the land, but it lacks legitimacy. So does its implementation.