Around 50 million uninsured Americans consume around $43 billion of healthcare in a year, and this tab is picked up by those with insurance. When Barack Obama signed the Patient Protection and Affordable Care Act into law in March 2010, it called upon states to expand coverage to almost everyone earning up to 133% of the federal poverty level, with affected Americans required to either obtain insurance or pay a penalty, and thus sought to bring another 30 million into the health insurance net. But legal challenges ensued against what 26 states argued was a revolution in the relationship between the central government and the governed. The laws fate has been hanging fire, with Obamas reputation on the line alongside. This is his signature legislation; many say he has used up most of his political capital here at the expense of investments in, say, the economywhich routinely scores much higher in polls of peoples preoccupations. But there is also a school of thought that history will see Obamacare at a level with FDRs Social Security and Lyndon Johnsons Medicare. This is now a possibility as the US Supreme Court has refused to repeal the law, although various surveys had yielded long odds in the other direction, mostly because they had expected the Chief Justice to swing the Court 5:4 in the Republican direction. He didnt, not entirely.
By upholding the penalty clause but only as a tax, Justice Roberts has given the Republicans a really tasty morsel to chew through this election year. Sarah Palin immediately tweeted, He said it wasnt a tax. Obama lies; freedom dies. More seriously, many Americans remain uncertain that the proposed system will be more sustainable and efficient than the present one, where they spend 17.6% of national income on health, more than any other OECD country by far. Still, the bottom line today is that Obama is going to have a nice weekend and Mitt Romney will be feverishly revising his stump speeches.