Obamacare Ruling a Landmark Win for President

Obamacare Ruling a Landmark Win for President
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In every White House, there are emotional moments of exultation triggered by achievement, victory or risks rewarded. The joy quickly ebbs, but when the high-five moments strike, they remind presidents why they wanted the job in the first place.

President Obama, Vice President Biden – and every Democrat who supported the Patient Protection and Affordable Care Act five years ago – experienced a mood-lifting moment Thursday when the Supreme Court ruled 6-3 that Congress intended to help consumers afford the costs of private health insurance, no matter where they happen to live. 

To “build something better for generations to come – that’s why we do what we do,” Obama said in the muggy Rose Garden where White House aides and top administration officials beamed their shared satisfaction just off-stage. The president’s signature and still-embattled legislative achievement survived yet another challenge. 

The president turned to Biden, who once dubbed the health law a “big, f---ing deal,” and with a theatrical glance mentioned years of “successes and setbacks. The setbacks I remember clearly.”

More than 16 million people have health insurance under the law, and its benefits to families, to states, and to the economy are measurable and undeniable, Obama argued.

 “That’s the whole point of public service,” he said, before walking back into the Oval Office, his arm around the vice president

It was a lofty day and perhaps a fine week to be Barack Obama.

Health care reform, the endeavor the president and fellow Democrats undertook during his first term, “is here to stay,” the 44th president declared. 

Obama pressed for reforms at the outset of his presidency despite the failure of President Clinton and first lady Hillary Clinton to get Congress to even vote on universal health coverage in the 1990s. More than 20 years later, even faced with 45 million people without insurance, Americans remained torn. Support for the Affordable Care Act, enacted with no Republican votes in Congress, has remained lackluster in polls, according to a recent CBS News/New York Times survey.

But on Thursday, health care amounted to a decisive victory at the White House, and not the only achievement Obama celebrated.   

The president’s trade agenda, procedurally torturous and politically dicey, cleared Congress this week with support from Republicans and despite outspoken opposition from some Democrats. Obama argued a pending trade pact negotiated with 11 other nations, mostly in the Pacific Rim, will greatly benefit the U.S. economy and counter the influence of China. The president and his team won legislation that will let Obama return to Congress with a 12-nation pact, but one that lawmakers have to vote up or down without amendments. 

And later this month, if the administration secures an enforceable nuclear deal with Iran, Obama will boast that he gambled in search of a new approach with Tehran and led international allies to make the world safer.

In a climate of divided government, a hotly contested 2016 presidential race, and an angst-ridden electorate, victories in the legislative and judicial branches in the same week spelled L.E.G.A.C.Y. enhancements for the president. 

The Supreme Court will issue additional rulings by Monday, including its decision on same-sex marriage – an issue of civil rights, according to Obama and all the declared Democratic presidential candidates. 

Back in September 2005, when the Senate confirmed John Roberts to the high court, hundreds of conservative Republicans and court-watchers gathered in the East Room to celebrate. President George W. Bush, basking in the standing ovation alongside Roberts, experienced the kind of momentary joy and sense of legacy fulfillment that occupants of the Oval Office encounter so rarely. “This is the administration’s best day,” one attendee commented from the back of the room. 

A decade ago, few Democrats, including then-Sen. Obama, who voted against Roberts’ nomination, could have predicted the chief justice would help rescue a Democratic administration’s health care overhaul not once, but twice. Whether as a result of Obama’s law, his luck or the nature of an evolving Court, conservatives, including Justice Antonin Scalia, again found themselves on the losing side of a ferocious legal and political debate Thursday. With a majority of the Supreme Court of the United States so heavily invested in the law, Scalia suggested, it could be called “SCOTUScare.”

"The Court's decision reflects the philosophy that judges should endure whatever interpretive distortions it takes in order to correct a supposed flaw in the statutory machinery,” Scalia wrote in his dissent, backed by Justices Samuel Alito and Clarence Thomas. “That philosophy ignores the American people's decision to give Congress `[a]ll legislative Powers’ enumerated in the Constitution."

In 2012, the Court affirmed the constitutionality of the law’s insurance mandate by a 5-4 decision written by Roberts. The administration for months predicted the justices would agree that Congress intended federal tax subsidies to help consumers whether they purchased private insurance policies through federally run or state-run marketplaces.

Roberts, writing for the majority, concurred: "The statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very 'death spirals' that Congress designed the Act to avoid." 

In the Rose Garden, Obama said the law “is not a set of political talking points,” and he encouraged its detractors to switch gears and look to the future. “This is health care in America,” he said.

The president wants governors, some of whom are running to succeed him as president, and GOP-dominated state legislatures that declined to accept the health law’s expanded federal benefits under Medicaid, to reverse course.

“We’ve still got states out there that, for political reasons, are not covering millions of people that they could be covering, despite the fact that the federal government is picking up the tab,” Obama complained.

Nineteen states have not adopted the law’s Medicaid expansion option.

The president’s spokesman said politics, not policy, blocks additional progress to cover more Americans under federally funded Medicaid, the health care program for low-income people overseen by the federal government and the states and expanded by the health law.

But the Supreme Court’s ruling Thursday opened a door to the possibility that “some of the political freight that has been attached to the Affordable Care Act might at least have been jostled loose,” White House Press Secretary Josh Earnest said.

In Congress, the potential for bipartisan collaboration, for instance to fix a medical device tax, a change supported by members of both parties, seems remote because of ingrained GOP opposition, he added.

The Affordable Care Act’s legislative nips and tucks will wait for a new president and another Congress. Or perhaps a future court decision.

“I think principally because of all of the politics that's been infused in this debate from the beginning, we haven't seen, at least to my mind, a genuine bipartisan constructive effort to strengthen health care reform in this country,” Earnest said.

Alexis Simendinger covers the White House for RealClearPolitics. She can be reached at asimendinger@realclearpolitics.com.  Follow her on Twitter @ASimendinger.

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