Like everyone else, yesterday’s excitement got to me. The case was monumental—one of those things that happens once in a lifetime. Not only was I personally genuinely interested, I got to help tell the story.
I must also admit that CNN’s screaming “Mandate dead” announcement—while others were reporting different outcomes—gave me an extra adrenaline rush (or at least scared me as we were reporting the opposite).
But today my excitement has slowed down. After a long work day that entailed writing a handful of stories, editing others and monitoring a constant roster of interviews and responses, I have to admit the big decision has made me a little tired. And that’s partly because though I expected the decision to give us an ending, I'm beginning to realize that’s not the case.
I expected the Supreme Court to rule the way it did—so much so that the story I wrote about the court upholding the law was penned the night before. I was ready to hear it, accept it and move on as both a health care reporter and as a consumer.
But much like Al Gore (or maybe someone who earns a living asking a lot of questions), I couldn’t accept it.
Immediately, there were questions:
Why did Chief Justice John Roberts change his usual conservative tune? Why the heck would Obama say the mandate wasn’t a tax shortly after that was the reason the Court gave for upholding it (these will be great soundbites for the Romney camp later on)? Sure, the law provides more access, but how are we going to pay for all this? Will there be enough doctors for the growing number of insured Americans? Will states and employers be able to implement all these changes in time? Will this help Obama win reelection, or give more ammo to Romney to win the presidency?
Sure, I can try to give answers to all these questions, but I’ll save myself the time and the backlash by giving a collective one: Health reform isn’t settled. As the Carpenters would say, we’ve only just begun.
The Supreme Court ruled the law constitutional, but it didn’t say whether it was a good idea. In fact, some said it was an entirely bad idea. That debate is not going to go away any time soon.
And more than that, the waiting game isn’t over. Regardless of the fact that the Court did, in fact, uphold the law, employers and states are still going to drag their feet on implementing changes.
First they said they were going to wait until the Court decision, and now it’s going to be about something else. They’ll wait for a repeal vote. They’ll wait for the November elections. Heck, maybe they’ll wait until 2014, when someone finally makes the changes for them.
Republicans will use repeal and replace as a rallying cry. And they have a good chance of making some noise: There are reports about employers not hiring due to PPACA; insurers are talking about the law increasing costs; and doctors are discussing the backlash it could create. (And that’s a short list.)
Doctors have a good point (and shouldn’t they be the ones who know?). Our health care system is absolutely flawed, but the law will have little impact on patients’ access to medical care. And it will do nothing to help high costs, except if you count causing them.
Health insurance doesn’t always equate to health care, just as a Supreme Court decision doesn’t always equate to an ending or to an answer.