March 30, 2012

The real reason why the Supreme Court will trounce Obamacare

John O'Connor, editorial director, McKnight's Long-Term Care News

Expect plenty of posturing and forecasting about Obamacare during the next three months. That's because the Supreme Court has until the end of June to decide whether the nation's new healthcare law is taking indecent liberties with the U.S. Constitution.

Personally, I'm not sure why so much hand wringing is taking place. For as they like to say in Chicago, the fix is in.

Cases involving corporate interests have been a no-brainer since Republicans assumed a majority on the nation's highest court. I'm not criticizing that reality. I'm merely pointing it out. If Democrats ruled the highest court's roost, the Left would be in business. As is, most justices on the nation's highest court never heard an argument from a corporate attorney they didn't like.

So forget about reading tea leaves, previous legal precedents and so-called moderates on the court. When in doubt, assume these justices will pay back whichever party is responsible for their lifetime employment. And for those of you keeping score at home, that's currently 5-4 in favor of the GOP. That will almost certainly be the score when they vote to kill — or at least severely dismember — the Affordable Care Act.

The big local issue is what full or partial repeal will mean for this field. Opinions differ here, but I'm inclined to side with those who say repeal will be a good thing. Why? Because the new law would certainly have put a lot more non-nursing home eligible people on the Medicaid rolls. To put it selfishly and bluntly, that would have meant more non-residents consuming Medicaid dollars. So to the extent that there will be Medicaid pie to eat, operators will not have to share as much.

Of course, few political victories don't leave a scar. Repeal of the law probably will officially accomplish what the Department of Health and Human Services has been trying to do for the last half year: finally kill the CLASS Act. That would appear to raise a deep philosophical question: If you put a zombie out of its misery, are you really killing it? Regardless, advocates of increased long-term care coverage will need to revisit the proverbial drawing board, maybe even a real one.

But back to the Supremes. These are supposedly some of the sharpest legal minds on the planet. Yet when push comes to shove, they vote straight ticket more loyally than most patronage workers. But as Dad used to say, it's not just about whom you know. It's also about whom you owe. That would appear to hold true whether one's day job involves pushing a mop bucket or donning silk robes.