Putting Obamacare to work

Mitt Romney wants to repeal it and replace it, but with what?

One of the ironies surrounding Obamacare is that, according to polls, people like its provisions. They like being able to keep their kids on their insurance policies until they’re 26. They like prohibiting insurance companies from denying coverage to people with pre-existing conditions. And they agree that companies with more than 50 workers should provide health insurance for their employees.

They just don’t like Obamacare. In particular, they don’t like the individual mandate. What they don’t seem to realize is that they can’t have the provisions they like without the individual mandate. The mandate that everyone buy insurance, including the young and healthy, is what will enable the insurance companies to pay for those provisions.

That ultimately is what Supreme Court Chief Justice John Roberts and four other justices understood when they upheld the constitutionality of Obamacare.

Now it’s time to put the Affordable Care Act to work. It’s a historic accomplishment, but it’s also far from perfect and will need tweaking as it goes along. It relies too much, for example, on a troubled Medicaid program, in which obtaining a card is one thing, finding a doctor willing to accept that card quite another. Bit it’s a start toward insuring that most Americans have coverage.

On the day of the ruling, Mitt Romney stood at a podium that read “Repeal and Replace” and vowed to act to repeal Obamacare on his first day in office. What he didn’t say is what he’d replace it with. He’s in the awkward position of being forced to run away from Romneycare, his signature achievement as Massachusetts governor and the model for Obamacare, to please the Republicans’ conservative base. The court’s decision isn’t making it any easier for him.