If the Movement Conservative Justices on the Supreme Court kill the ACA, and do so out of raw ideological zealotry to hurt President Obama, they are even bigger buffoons than many imagine.
There is a strange phenomena that occurs very often within Movement Conservatism, and that is the idea that killing an attempt at a solution to a problem is somehow the very same thing as fixing the original problem itself. How many times have you heard or read a conservative media pundit or politician talk or write about cutting food stamps and public assistance where they'll end up using language and framing as if cutting food stamps is actually attacking hunger itself? As if taking away access to affordable and accessable food for the hungry is going to result in less hunger and not more? Aside from the infuriating nature of the cold-hearted callousness of it, there is something tactically self-defeating in this practice of pretending the old status quo was ideal when it was anything but because it is functionally like mailing a homemade bomb to yourself down the line. Healthcare reform, in an age where literally tend of millions of Americans were forced to use the emergency room as their primary care physician, had to happen.
You kill a viable attempt at a lasting solution to a very real problem as if that very real problem was simply a malicious and mendacious fiction simply cooked up for purely ideological purposes, and then that festering problem gets much, much worse in the wake of your actions. Killing, or even crippling, the ACA would be choosing to go about creating an additionally manufactured crisis to go along with the original festering problem suddenly coming roaring on back into the picture. The old status quo was not fine, but a nation heading towards a crisis. Which is why HCR was necessary in the first place. In that new paradigm the odds of an unavoidable crisis occuring more quickly and out of your ability to manage it as it happens increases dramatically. The self-addressed policy bomb will be that in re-addressing this national problem when it is a disaster it will be handled in an atmosphere of crisis. In a place where months or even years of debate, debate that can be hijacked and manipulated, will be curbed.
The results under those circumstances will be vastly more in the direction of establishing public and private policies that will make the original objected to policy on partisan grounds seem like an ideological dream to you in hindsight.
The old status quo was not, and is not, sustainable, so the healthcare system was going to be changed either by the system breaking down or by something like HCR before it finally did. It is actually tactically, strategically, politically, and even ideologically in Movement Conservatism's best interests to see all of the ACA upheld. The pain that Scalito killing off the law would cause would be massive, the resulting financial losses would be equally massive, and the pain of the status quo's return would all be on Movement Conservatism. No spinning that away no matter how much Koch Brothers and Fox News bullshit they tossed up.
1. Striking down the ACA fundamentally changes the national conversation away from the friendly Teahadi confines of what is "bad" and "unfair" about it and how it was all "passed along partisan lines", to what is bad and unfair about its being taken away by it's death. There is a child-like quality to the fuckwit "I vote for the guy I want to have a beer with" low-information voter that comes into play. Only when they have something taken away do they realize they have been screwed out of something that they would have wanted and needed. The burden shifts from the President and the Democrats defending the plan, to the Right having to live with having it pointing out over and over and over again what the Right has jobbed the majority of the population out of. Not just the 30 million folks without access to affordable care now, but everybody. Millions beyond the uninsured and under-insured are going to get screwed out of a good deal, and they are going to figure that out once they are screwed. There is a lot of things the public loves about the ACA if you discuss those things one by one away from the package that has been demonized. The Right created a lot of static to keep people confused and angry about the bill, but after it is hypothetically gone, that is when what you have been rooked out of will get a big second look.
2. The status quo being unsustainable, it cannot be returned to indefinitely. Reform will be planned carefully in advance or forced on the system when the system breaks. The only options available afterwards will be to do nothing, which is not an option, or tackle a new law.
3. If the ACA is struck down, the Rightwing justices will be labeling their own beliefs and ideas to preserve the free-market in healthcare via HCR unconstitutional. This is a huge deal. The only options available afterwards will be to do nothing, which is not an option, or tackle a new law. It cannot be understated how much of the ACA is grounded in free market conservative thinking, and how dramatic an effect this would have on a new bill. For a future revisitation of HCR, one that clearly and undeniably passes constitutional muster, this will be a bill that is based around Medicare. For All. One that is by it's very nature far more liberal and more deeply involve the public sector that would ever have resulted from the ACA era status quo. This is the closest thing the Right will ever get to a Movement Conservative Healthcare plan. Ever. Free market based. Preserves the private insurance industry. Keeps corporations, and corporate profit, in the equasion. There is nothing left in terms of policy to be considered that the Movement Conservative Right will find a better alternative. I can think of few things more damning to the future of Movement Conservatism than rightwing justices, in a fit of Obama Derangement Syndrome for the ages, undermine conservative policy in a way that charts a clearer path for far more liberal policy to be the constitutional way to go.
4. Even the dimmest most easily concern-trolled into navel-gazing beltway Democrat will no longer be able to believe, or keep a straight face when told, that passing conservative policy to achieve liberal ends is the most viable strategy. Not after the defining 'fuck you' of an era of this much bad faith and dirty dealings from the Right being thrown down. The Obama administration has been slagged as radical and leftist no matter how middle of the road and carefully parsed for centrism, or even conservative, it's actions and policies have been. It's hard not to see the Obama administration embracing gay marriage and halting deportations of children who were brought into the country illegally years ago as a sign that, since no matter what you do is going to be slagged as the worst thing ever, you might as well not worry about the outrage machine and just chart your own course regardless of the noise. Why try and ever please the unpleasable again? Doing so will neither innoculate policy and legislation from Movement Conservative bad faith, or be given a fair hearing by RW judges. You might as well pound sand because there is no conservative policy or idea that will not be labeled as radical leftist if a Democrat passes it. This would be a paradigm shifting 'fuck you' in so very many ways to both lawmakers, and to voters, and there are many, outside of Movement Conservatism. As long as a Democrat passes it, no matter what it is, it's the worst thing ever.
5. The healthcare battle will not be over until the healthcare problem is finally addressed.
If the worst case scenario happens between now and the election, it will be a dark day for this nation and its people, but should it happen I would hope everyone on our side, the side of trying to bring the dream of affordable care to millions who go without, realizes that it will also be a longterm own goal for the Right that they will delusionally celebrated as a walk-off game winning score. This would not be the end.
If the Movement Conservative Justices kill the ACA, the fight for reform is not over, because it is not a fight born out of self-indulgent ideological pique. The talking points and sneers about "elitist overreach" is not what is now, nor ever been, fundamentally driving this entire policy debate as much as they might wish this to be so. A real problem is the problem, and it is not going away because they kill a good faith attempt to deal with the issue should it happen.
This is the worst of all worlds for Movement Conservatism should the ACA be struck down in the longterm. I'm having a hard time believing that they could be that stupid, but they could be.
If the logic is that the mandate is unconstitutional, and that a 5-4 majority finds that they are not just content to kill the mandate but the whole law with it, so the whole thing goes, all the possible outcomes down the line will be vastly more liberal, and more related to involving the public sector rather than fixate on finding a market-based solution, than current law they hate and that they, bizarrely, find so ideologically objectionable.
Making Medicare Medicare for All is constitutional. A Medicare buy-in would be too. There isn't any serious legal scholar in the nation who has argued that this is not so. If you explore the various alternative ideas for reform, this is the best the Right will ever get, because their dream of 'going back to the way it was' is a massive delusion.
The Right should be careful what they wish for. The conservative movement isn't going to like what happens with healthcare reform should they kill the ACA, and they aren't going to like the lasting damage they do to themselves as collateral damage to killing the law down the line.
Here's hoping that one of the Scalito borg realizes that before it is too late.