WASHINGTON (AP) — President Barack Obama’s health care law would not automatically collapse if the Supreme Court strikes down the unpopular requirement that most Americans carry medical insurance or face a penalty.
The overhaul could still lurch ahead without that core requirement, experts say. But it would be more like a clunky collection of parts than a coherent whole.
That would make an already complicated law a lot harder to carry out, risking repercussions for a U.S. health care system widely seen as wasteful, unaffordable and unable to deliver consistently high quality.
Premiums could jump for people buying coverage individually, and for small businesses. That’s because other provisions of the law require insurance companies to accept people with health problems, and limit the premiums that can be charged to older adults.
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Sooner or later, the dilemma of the nation’s 50 million uninsured would land back on the doorstep of Congress.
During Tuesday’s oral arguments, the Supreme Court’s conservative justices fired off sharp, skeptical questions about the constitutionality of the mandate, fanning speculation that it may not withstand review.
It’s unclear what the court will do in the end, whether it will let the law stand or strike the whole thing down, or invalidate only the mandate.
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The insurance requirement is unprecedented in federal law, but it is not the only lever for expanding coverage in Obama’s legislation.
“The hyperbolic language that is being used about this is way over the top,” said economist Gail Wilensky, who ran Medicare and Medicaid under President George H.W. Bush. The mandate “is important, but not that important. There are other strategies to encourage people to purchase health insurance.”
If the mandate only is struck down, the law’s Medicaid expansion would still be carried out under a separate provision. The Medicaid expansion also is being challenged, but no lower court has found it objectionable.