Many years ago (ancient history for many, since it was in the last century) a certain Colorado Governor demanded the reform of Colorado’s health insurance regulations, or he’d bring a “single payor system” down on our heads. it was to be called, if memory serves, ColoradoCares. Reform happened, so it went away. But you know, the relentless need to have a government-run health care system never goes away with Democrats.

Well, its back, and it’s even worse. Here’s a quote: ” a “risky and untested state-run health insurance system.” State-run, as in, the state of Colorado, and financed with a whopping big tax increase, larger than the size of the entire Colorado budget. It will replace Obamacare. And no, that would not be the kind of replacement I’d be in favor of!

If you love Obamacare, you’ll love this – until you don’t.

Read the full story here.

Media reports suggest that today (or, at, least, this week) the Supreme Court will hand down its decision on The Affordable Care Act. To briefly recap, dozens of states sued the federal government to overturn the act; the reasons for that suit are varied, such as the individual mandate, but include such issues as Medicaid funding requirements, which is a huge unfunded liability for states.

I’ve resisted the urge to handicap the forthcoming possibilities, but I do have an opinion. Right or wrong, I’m going to publish it today; one way or the other, the debates between Mr. Obama and Mr. Romney about health care in the upcoming general election will be fascinating to discuss in light of what the SCOTUS decides.

There are four possible outcomes: to do nothing and leave the entire Act standing; to narrowly strike down just the mandate provisions; to strike down the mandate and two other major provisions (which is the position that the Obama Administration said should happen if the Supremes conclude that the individual mandate is unconstitutional), and the fourth: declaring the entire Affordable Care Act unconstitutional.

I have no idea what the “Vegas line” is on this decision, so, I will take my shot-in-the-dark and lay odds:

Do nothing: 12 to 1. Not likely.

Strike down just the individual mandate: 6 to 1. Too narrow, and creates a bigger problem.

Strike down the mandate and the provisions relating to it (the position argued by the Administration if the mandate is unconstitutional): 4 to 1. The Administration wins, and the remaining Act becomes a rallying cry for progressives who always wanted the single-payor option (and this decision almost guarantees it).

Strike down the entire Act: 3 to 1. The most sensible solution of all.

My reasons for giving the best odds for striking the entire Act lay in the unprecedented suit brought by a coalition (frankly, a majority) of states against the federal government. I’m unaware of any action brought against the government by so many states, and this alone should prompt an unprecedented examination of the role of the federal governments’ power to pass legislation that intrudes on the right of the states to govern themselves. It also bears pointing out that the federal government is, technically,  a government of limited powers (the term “states rights” is not a pejorative for discrimination, despite what liberals have always said) with the remaining powers reserved exclusively to the states. With the individual mandate exceeding any rational understanding of the purpose and use, even in liberal hands, of the Commerce Clause, the demand by the states to be relieved of a burden they clearly feel is unconstitutional has to be carefully considered. The strange manner in which the Act was passed, the lack of ANY bipartisanship (or, of that matter, any input from anyone except the Progressive Caucus in the bills ultimate form) the distorted cost projections, not to mention the majority view of the Act across the nation by voters – all of these things must be taken into account by the Justices. Never mind that they are legal scholars who pass judgment on constitutional issues at the highest level; there is and always will be a political element to every controversial Supreme Court decision. Couple this with the lack of a severability clause, and my opinion is that the Supremes err, not on the side of caution, but on the side of good sense: telling Congress that this legislation is so flawed and so intrusive that it would be best to just start over.

And that is what I think the Supremes will do. If they don’t, they will be performing a major disservice to the country, by leaving in place a huge entitlement program that completely remakes the social contract between the government and its citizens (or should they now be called subjects?) without any rational means to pay for it (assuming that the Commerce Clause doesn’t allow the government to tell you what you must buy), while dooming a portion of the insurance industry to almost-certain extinction or, worse, outright nationalization or regulation as a monopolistic utility, with the government calling ALL the shots, while re-distributing massive tax increases to pay for it.

Whatever they decide – it’s going to be interesting. And don’t forget that, in the absence of any new federal legislation, states, including Colorado, will be in a position to craft their own solutions, which is how it should be in the first place. The fact is that Colorado state Republicans control the House by a slim one vote margin – and history shows that in the early 90’s, Colorado’s Governor Roy Romer (D) threatened to pass a single payor system unless “health reform” was enacted, which set us upon the very path we now walk.

Let the games begin! Quoting Rep. Michele Bachmann: ““The decision on Obamacare goes well beyond health care,” she wrote. It “will determine whether or not the court believes the government has a right to mandate that Americans buy a product or service, a direct impact on our freedom and liberty.”

This has been an interesting month, as HHS continues its assault on the health insurance industry, religious freedom, and the hollowing out of the promise made during the passage of Obamacare not to impose abortion on the majority of citizens who oppose federal funding for abortion, not to mention abortion-on-demand. And, lastly, The Congressional Budget Office (CBO) finally tells us that, lo and behold, Republicans were right when they tried to point out, to a deaf and dumb press, that the Administration was cooking the books in it’s original cost estimates for Obamacare, and that the estimates were in fact, inaccurate. Garbage in, garbage out, as always. (And then there is this ludicrous piece, written in Forbes, of all places, that tries to make the point that the new estimates aren’t in fact an increase, and…well, I’ll let you read it and figure out exactly where the writer is missing the boat.)

But most interesting of all, I think, is the orchestrated PR campaign being coordinated by the White House for the oral arguments on the constitutionality of Obamacare before the Supreme Court. The Center for American Progress, Families USA, Health Care for America Now, and Protect Your Care are among the groups (“partner organizations”) mentioned in a leaked strategy memo, all of them left-wing advocacy groups, at least one of which is an open supporter of single-payor health care. The PR campaign, on the second anniversary of Obamacare, targets the “core constituencies” of women, young adults, and others who benefit from Obamacare. See the full story here, and the memo here.

• An excerpt: “”Remind people that the law is already benefiting millions of Americans by providing health care coverage, reducing costs and providing access to healthcare coverage. This message will include the ideas that these are benefits that politicans/the Court art (sic) are trying to take away from average Americans.”
• And: “Frame the Supreme Court oral arguments in terms of real people and real benefits that would be lost if the law were overturned. While lawyers will be talking about the individual responsibility piece of the law and the legal precedence, organizations on the ground should continue to focus on these more tangible results of the law.”

In other developments, HHS finalized the rules governing “health insurance exchanges” which, in the opinion of many, are a defacto takeover of state-regulated health insurance, since the exchanges, and the regulations which govern them, inevitably lead to a decrease in state sovereignty and a strengthening of federal control, via a “one size fits all” regulatory approach which, contrary to the HHS press release, will not reduce rates, since it’s only mechanism, pooling, has limited ability to fix rising premiums. Let me put it another way: if pooling was all it took to reduce health insurance premiums, then larger employers, so the story goes, have an advantage over individual and small groups because they can negotiate lower rates. Assuming this is true, then working for the largest employer in Colorado – the state government – would automatically give you lower rates. But this is false: Colorado state employees have very high rates for insurance coverage, $444.46/mo. for an employee on a PPO plan, and more than $461/mo. for a single employee on a Kaiser HMO plan. This is higher, actually, much higher, than competing plans on a small group basis that I place with employers, and substantially more expensive than individual plans (which aren’t guaranteed issue). See the rates and benefits here. Lastly, they aren’t even great plans. So much for “pooling” being the antidote to continued federal messin’ in the delivery of health care: it isn’t so. And the exchanges won’t be any cheaper.

Lastly, the federal government, as it often does, purposely misses the point when it comes to the actual mechanisms in place for large employers to manage their health care costs, namely, self-insurance. While pooling has an effect on the overall premiums charged, ultimately it is the way the contract is written, managed, and back-stopped with stop-loss coverage that makes all the difference. As with the contraceptive controversy, federal regulators at all levels show an appalling lack of interest and expertise in how insurance markets, or for that matter,  insurance risk pooling, really work, probably because they aren’t advocates for real insurance mechanisms, preferring their ivory tower academic approach of vilifying “evil insurance companies” and advancing their sacred, pet solutions embracing centralized control and redistribution rather than free-market approaches.

“The Founding Fathers knew a government can’t control the economy without controlling people. And they knew when a government sets out to do that, it must use force and coercion to achieve its purpose. So we have come to a time for choosing.” – Ronald Reagan