The Supreme Court decision upholding the Affordable Care Act (also known as “Obamacare”) has triggered a predictable debate among right wing politicians and opponents of President Barack Obama. On the national level opponents are promising to undo the legislation. On the state level they are promising to refuse to implement its provisions which expand Medicaid coverage for the poor and uninsured. Never mind the fact that the federal government will finance about 95 percent of the cost of Medicaid expansion from 2014 through 2019.


And for politicians such as former Massachusetts Gov. Mitt Romney–the presumptive Republican presidential nominee who crafted an almost identical health plan when he was in office, a plan which was the template for the federal law–the principal reason for opposition appears to be simply that President Obama supports it.


But studies by the Henry J. Kaiser Family Foundation have revealed some interesting contradictions to the rhetorical narrative dominating the conservative talking points on the topic.

For one thing: “a majority of Americans (56 percent) say they would like to see the law’s detractors stop their efforts to block its implementation and move on to other national problems,” according to a Kaiser Foundation study conducted shortly after the Supreme Court decision was announced.

In addition the foundation discovered, the states most adamantly opposed to the implementation of “Obamacare”–Louisiana, Alabama, Arkansas, Georgia, Mississippi, South Carolina, Arizona, Florida, and Texas, for example–are also the states with the highest rates of both uninsured children and adults, and the highest rates of children and adults requiring Medicaid assistance, and they are the states with the most significant problems with poverty. In other words they are the states most in need of the beneficial provisions the law provides their often indigent residents.

Democrats, for their part argue that the time has passed for quarrelling about the law, for looking backward, or for rehashing the healthcare plan which has now been validated by all three branches of the federal government: it was legislated by both houses of Congress, signed into law by the president, and upheld by highest court in the land.

“Now is not the time to spend four years fighting battles we fought two years ago,” the president told a campaign rally in Mawmee, Ohio July 5. “Now is the time to move forward and make sure that every American has affordable health insurance and that insurance companies are treating them fairly. That is what we fought for. That is what we are going to keep. We are moving forward.”

The president’s argument may have already gained some traction.

“There is a precedent for this,” Sen. Charles Schumer (D-N.Y.) told reporters just hours after the Supreme Court decision was announced. “When Social Security was passed, it was decried as socialism, just like healthcare. Like healthcare, it withstood a Constitutional challenge early on, and of course Social Security went on to endure as a cherished program in the country. The healthcare law is getting more popular with time, as more and more of it goes into affect.”

Meanwhile, some health care experts suggest it’s unthinkable that some state leaders would really opt out of any parts of the Affordable Care Act, since the vast majority of the costs are covered by the federal government–paid for by federal taxes their citizens will pay, whether the state implements the law’s provisions or not.

By opting out, a state would be walking away from millions and millions of federal dollars, leaving a significant portion of their citizens without health care in the process. Florida for example, according to the Kaiser Family Foundation, has the second-highest rate of uninsured Americans at 21 percent. The expansion of Medicaid in that state would cover 951,622 people, according to the foundation.

Ironically, Republicans have offered no proposal of their own to reform the healthcare system. They are content to point fingers at the president and his administration, condemning his record of some–however modest–reform, while utilizing their own legislative resources in the House of Representatives where they are the majority on symbolic “show” votes such as their 31st House vote held July 11, to repeal “Obamacare,” this, fully two weeks after it was upheld by the Supreme Court.

Related news:

High court upholds health care act; Republicans keep fighting (FCN, 07-10-2012)

Supreme Court hears ‘Obamacare’ arguments  (FCN, 04-05-2012)

Bridging the gap in health care coverage for children  (FCN, 06-27-2010)

Harvard study: 45,000 uninsured Americans die every year  (FCN, 09-24-2009)

Congressional cowards and health care reform  (FCN, 07-07-2009)

The connection between wealth and health  (FCN, 06-06-2006)