That’s pretty much what happened with the Supreme Court’s King v. Burwell ruling.
After all the hype and chatter, the basic fact is that the Affordable Care Act--Obamacare--is still law. The health care status quo is still in place, and that’s not a good thing. We’re still stuck with the mandates, regulations, and taxes.
While the law expanded coverage, the flaws that have made health coverage more expensive for employers and workers still remain. Thomas Miller at the American Enterprise Institute summed it up well, “The law and its regulatory mutations still don’t and won’t work well.”
So it’s back to work to fix the law’s many problems. Here are five:
- Employers still have a perverse incentive to hire part-time workers over full-time ones. A University of California—Berkeley study found 2.3 million workers are at risk of having their hours cut.
- The medical device tax continues to punish companies, forcing them to reduce investments and hiring and making them less globally competitive.
- A $189 billion tax on health plans, the Health Insurance Tax in effect since 2014, is hurting small businesses that buy insurance on the fully-insured market. The National Federation of Independent Business estimates that the tax will cost up to 286,000 jobs.
- Small businesses are about to get hit with fewer health plan choices and higher costs, because Washington will expand the small-group market in 2016.
- The 40% excise (“Cadillac”) tax on high-value health plans is still on track to hit millions of workers and employers in a few years. The tax, opposed by both unions and business groups, is designed to eventually hit every health plan.
Anyone hoping the Supreme Court would fix the health care law is disappointed. However, the other two branches of government should see this collective focus on health care as an opportunity to recommit to actually reforming our system to expand access, improve quality, and control costs.
Looking at the list above, they have a lot of work to do.
UPDATE: This Politico story adds some detail to the case I make above:
The ruling “still doesn’t change what the law is doing,” said Rep. Phil Roe (R-Tenn.). “I just had lunch with some people looking at the 40 percent Cadillac tax. We’ve still got a lot to do.”
The “Cadillac tax” on high-cost employee health insurance plans, which goes into effect in 2018, is vehemently opposed by labor unions and some Democrats on Capitol Hill.