The study of politics may be called political science, but we all know that politics is a game. Political outcomes that seem linear and preordained (SCOTUS dismantles Obamacare = Americans less likely to vote for Obama) aren't always what they seem. Obama can win the politics if the Supreme Court overturns large portions of the ACA, and his approach doesn't have to be complicated.
Here are the facts: the Republican noise machine and echo chamber have made Obamacare unpopular overall, but the individual elements of the plan are actually popular. Moreover, Obama's Republican opponent, Mitt Romney, implemented a health care overhaul in Massachusetts that is not only shockingly similar to Obamacare, but is popular and has worked. Moreover, there are provisions in the ACA that are both enormously popular and have already been enacted.
This is not the hopelessly unfavorable political environment one would expect the president would have to tread, despite what horserace-obsessed media narratives might anticipate, should the Supreme Court overturn the ACA in its entirety. Instead, the president will have a chance to simply and boldly state what the Supremes have rejected, what his opponents might be gloating over, and what must be done right now.
Here's a paraphrase of what I think Obama should say, minutes after a Supreme Court takedown of the ACA, in an address to the American people:
"My fellow Americans, the Supreme Court has just ruled that the Patient Protection and Affordable Care Act, the health care reform law that Congress passed and that I signed into law 2 years ago, is unconstitutional. I vehemently disagree with that ruling, but those beliefs are irrelevant. I respect the Court's decision as the final say on what adheres to the tenets of our Constitution. But as president, I have a responsibility first and foremost to our national security, and the health of every American citizen is a national security issue. Here, simply, is what the Supreme Court's decision has put at risk:
Insurers can again deny children health care coverage because of a pre-existing medical condition.
Insurers can again deny children under 26 years old from joining their parents' health care plans.
Insurers are no longer required to spend 85% of their revenue on health care expenditures, and the $1.1 billion in rebates this rule would have given back to the consumer are no longer guaranteed.
Insurers can once again impose lifetime caps on the dollar amount they have to spend on your health care coverage.
Insurers can once again charge for preventative medical testing--like colonoscopies, mammograms, certain pre-natal care and domestic violence screenings--that would have been covered in new health insurance plans starting August 1 of this year, or in 2014 for existing plans.
Citizens with pre-existing medical conditions can no longer join high-risk health insurance exchanges where they can obtain affordable health care coverage.
Seniors will pay hundreds or thousands of dollars more for their prescriptions, because the Medicare Part D drug rebate has been lowered.
Medicaid coverage will no longer be expanded to the neediest of us who earn up to 133% of the poverty level.
These provisions were all a part of the law struck down today. They are not possible outcomes of the law, they were the law. The Americans this law affected are not speculative beneficiaries, but real people with real health care needs.
Many other provisions of the Affordable Care Act, expanding accessibility, affordability, and transparency in our nations health care system, have been eliminated because of the Supreme Court decision. Many were part of health care laws drafted by Republicans. Many are part of the health care law my opponent in this year's election enacted in Massachusetts while he was governor of that state. Health care reform is a partisan issue, no doubt, but the need for health care knows no political or ideological boundaries.
The only question I have for opponents of the law, as enacted, is this: what are you going to do right now to keep children with pre-existing conditions covered by insurance? What are you going to do right now to keep children under 26 covered by their parents' health plans? What are you going to do right now to help the millions of Americans who were going to receive billions of dollars in premium rebates this year, or millions of seniors who were going to have cheaper prescription prices this year, afford the health coverage they need? If the answer is "nothing", then Americans have the right to know.
Starting tomorrow, my administration will be sending each provision of this law to an individual vote in Congress. Provisions of the law that have already been enacted, and that are helping people right now, we'll send to Congress first. But every piece of this legislation deserves a vote. To every representative and senator in Congress, I say this: if you don't like a piece of the Affordable Care Act, say so. Put your vote on the record. And let the people decide if your actions are for the good of America.
The Affordable Care Act may have been legislated in the abstract, and it may have been argued in front of the Supreme Court in the abstract, but the law dealt with real people that have real health care issues. The time for opposing health care reform in the abstract is over. Let's show each and every American how we support their health care in reality."