That "Horrible" Health Care Act, and Winning by Whining

In about a month, we'll be hearing from the Supreme Court on the Affordable Care Act. In the meantime, word has been circulating about one of the impacts that will be felt this year by consumers of this horrifying socialistic beast.

The story involves the "medical-loss ratio," which means the amount of money spent by insurance companies on all things except direct health care for clients. Under the ACA, the MLR for private insurers must be 80 to 20; that is, they must 80 percent of their expenditures on health care and quality improvement activities, and no more than 20 percent on overheard and marketing. It's 85-15 for large-group plans. If insurers fail to hit the mark, they don't get fined, with the evil gummint hauling in the cash. They owe the money back to their clients in the form of rebates.

The Kaiser Family Foundation estimates that $426 million in rebates will go out this year starting in August. But whether they go out will depend, of course, on what the Supreme Court does. On that point, the right is getting antsy, with the Journal editorial page fearing that John Roberts will cave in to the "intimidation" efforts coming from the White House and Senator Pat Leahy, among others.

The intimidation charge is silly, and self-incriminating. As if Leahy isn't allowed to express his views without us having to worry that poor John Roberts can't withstand it? It takes a certain type of mind to see such comments as attempts at intimidation.

First of all, I see no evidence that Roberts permits common sense, decency, evidence, or liberals' views to influence his thinking at all. Any man who could tell Seattle and Louisville that they're not allowed to push racial integration in their schools even after every party involved in the planning has agreed to a plan, and further agrees that much good and little harm is resulting, is hardly such a man. No siree. He's just calling balls and strikes.

Second, this is just the usual right-wing, Bobby-Knight-style chair-throwing. If they get the call and Roberts leads a 5-4 majority against the ACA, then it worked. If they don't, and Roberts is part of a 6-3 majority holding for the act, they may have lost on the merits, but they get to bellyache that it was all part of a plot by those evil liberals who will stop at nothing, not even perverting our most cherished institutions, to get what they want. So they get to win by whining.

As I've written many times, I'm of mixed minds on this one. Substantively I most certainly want to see the act upheld. Politically, an upholding could well just end up energizing the right wing to come out and vote in huge numbers. Of course if it's overturned that's bad for Obama in June, and maybe beyond. But a pro-ACA decision is almost certainly bad for Obama in November.

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Michael TomaskySpecial Correspondent

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