Obamacare’s Built-in Issues
The problem with the ACA is that it brought the problems of universal healthcare to everyone’s attention. Private insurance can’t cover a healthy young person’s $50/yr needs while simultaneously covering someone else’s $15,000/yr needs and charging both less than it would cost the healthy young person. So the ACA spread the cost out with an “individual mandate” or resultant penalty for everyone and a requirement that insurance companies drop their penalties for “high risk pool” individuals.
The answer has never been and will never be private insurance with a government mandate enforced by a penalty. The only answer is expansion of our current single payer system, Medicare. We all pay into it, ostensibly, and it is an efficient, well managed system whose only challenges are imposed by political agreements between lawmakers and profiteers.
Cheap Fines or Expensive Coverage?
I’m with you 100% on the fines. If insurance is mandated and the federal government is going to levy a fine against me if I don’t purchase it, shouldn’t there be an option that is guaranteed to protect my participation at the constitutional level? Religions argued that requiring reproductive health care coverage was anti-Jesus. Capitalists argued that free market forces would prevail (once the sick die?) Rural bootstrappers argued that whiskey and rest were all the healthcare they need.
The ACA put weak constitutional protections in place, but almost so weak that it seemed to be begging for a courtroom showdown. The first to be challenged was the individual mandate, and it was upheld only because the penalties were successfully positioned as taxes.
Nobody Disagrees with Reproductive Freedom
Then came the birth control mandate, and that was ridiculous. Nuns argued that allowing employees of Catholic hospitals to quietly add free reproductive health coverage to their employer provided insurance benefits, while shielding the Church from specifically providing this coverage, would force moral complicity in the use of contraceptives and medical procedures that result in the termination of pregnancy.
The Supreme Court took a pass and handed the case back to the parties, instructing them to form a compromise. Effectively, the religious organizations won the right to withhold fundamental aspects of healthcare coverage from its employees. The fundamental coverage guaranteed to all Americans by a law drafted by Congress and enacted by the President can be denied to any American by any employer claiming to answer to a higher power.
Of course The Church of Joe Nobody denying birth control coverage to gift shop employees will likely find defeat in any modern court, but making it to court is a much larger battle now that the precedent the SCOTUS has set is “We’re sure you can work this out without us.”