I’m still not sure whether Charles Krauthammer’s Friday column is actually a Stephen Colbert-like parody of over-the-top conservative opposition to President Obama’s health-care law.
From 2013 through 2022, the CBO reports, the costs of Obamacare come to $1.76 trillion....
It gets worse. Annual gross costs after 2021 are more than a quarter of $1 trillion every year — until the end of time. That, for a new entitlement in a country already drowning in $16 trillion of debt.
But nowhere does Krauthammer mention that the law also raises revenue and finds savings elsewhere to help pay for those costs. The same Congressional Budget Office cost estimate to which Krauthammer refers notes that the CBO “previously estimated that the [Affordable Care Act] will, on net, reduce budget deficits over the 2012–2021 period.” The CBO hasn’t updated that calculation with some of the new numbers it just released, nor moved it beyond the 2012-2021 window. Still, rather than acknowledging the law’s revenue provisions, which might mitigate the outrage, he leaves the reader with the sense that all the costs are to be charged to the national credit card. Which isn’t true.
Krauthammer would probably still object on the grounds that expanding government spending to provide wider access to health-care coverage is bad, even if the system is paid for. But that’s a very different argument than the one he seems to make.
Then Krauthammer tackles the question of the law’s constitutionality, and that’s when things really start getting really heated:
If the federal government can compel a private citizen, under threat of a federally imposed penalty, to engage in a private contract with a private entity (to buy health insurance), is there anything the federal government cannot compel the citizen to do?
If Obamacare is upheld, it fundamentally changes the nature of the American social contract. It means the effective end of a government of enumerated powers — i.e., finite, delineated powers beyond which the government may not go, beyond which lies the free realm of the people and their voluntary institutions. The new post-Obamacare dispensation is a central government of unlimited power from which citizen and civil society struggle to carve out and maintain spheres of autonomy.
Yet even if jurists who uphold the constitutionality of Obamacare’s “individual mandate” are misguided in their reading of the Commerce Clause in this instance, that obviously doesn’t mean they’re ready to throw out every word of the Constitution, close up shop and allow the political branches to do . . . whatever.
Krauthammer doesn’t even contend with the arguments of experts, conservatives included, who believe the law accords with mainstream understandings of the Commerce Clause, let alone explain how he thinks upholding Obamacare could eviscerate the Constitution’s many other enduring restrictions on government power. He doesn’t discuss how the particular characteristics of the health-care market inevitably entangle the federal government. Instead, he constructs a funhouse mirror representation of the stakes and leaves it at that.
Really, the law’s greatest flaw is one Krauthammer doesn’t even mention — that it doesn’t do enough to reduce America’s steady increase in health-care costs, a trend that predated the law’s enactment. Nor does he mention the risk that Congress might put off some of the law’s revenue-raising provisions in the future, which might have made his section on the law’s spending more sensible. Instead, he insists that the law represents “the worst of the Leviathan state.”
Obamacare has become a vessel into which conservatives have poured countless suspicions about liberals and their intentions. But it’s just not some outre left-wing plot. In past decades, it would have been considered a relatively centrist approach to expanding health-care coverage. That it isn’t now says more about many of its critics than about the law itself.
UPDATE: Minor edits added above for clarity.