Thursday was a good day for public health, nationally and in California. First, the U.S. Supreme Court rescued Obamacare from another farfetched legal challenge. Then the California Assembly stood up to this state’s own extremist voices to prevent a contagion like the Disneyland measles outbreak from happening again.
In both cases, the common good was imperiled by interests that seem blind, not only to social obligation but to enlightened self-interest. When people move through society with untreated diseases, everyone is vulnerable.
Yet opponents of the Affordable Care Act were so eager to kill the legacy of President Barack Obama that they were willing to seize on anything, even a drafting error.
And opponents of Senate Bill 277 were so whipped up by unfounded fear of vaccines – one of history’s great public health advances – that they stalked, threatened, demonstrated and filed recall petitions against state lawmakers who backed it, creating months of heightened security at the Capitol.
King v. Burwell hinged on the canard that the 900-page health care law should be overturned because of a single phrase that, if you squinted, could have a double meaning. The case had no business before the high court; Congress clearly intended to give all Americans access to good, affordable health care.
But conservative and libertarian zealots argued that, because of one sloppy passage, the federal government couldn’t legally subsidize health insurance in the many states that hadn’t established their own exchanges.
Because one imprecise sub-clause talked briefly about tax credits “established by the State,” they argued, Obamacare should only be legal in the states that, like California, had their own systems.
Had the Supreme Court ruled for the challengers, the national health insurance market would have been severely disrupted. And the ripples would have been felt here, where more than 12 million Californians rely on subsidized health insurance.
Fortunately Chief Justice John Roberts Jr., writing for the 6-3 majority, found that “Congress passed the Affordable Care Act to improve health insurance markets, not destroy them.” No doubt that disappointed Justices Antonin Scalia, Samuel Alito Jr. and Clarence Thomas, who dissented. (“Pure applesauce” and “jiggery-pokery,” Scalia called the majority ruling.)
But it must relieve Republicans in Congress, who can now freely campaign against Obamacare without having to come up with a better idea.
Here in California, the ruling just affirms the state’s wisdom in creating its exchange, Covered California. State Health and Human Services Secretary Diana Dooley said California will keep its own, and sign-ups will continue apace, although some other states may opt to join the federal exchange.
Meanwhile the vaccine zealots aren’t resting. They’re already filing recall papers against SB 277 backers, including Sen. Richard Pan, an author of the bill and a Sacramento pediatrician.
Like the anti-Obamacare crowd, they think their own wrongheaded intensity somehow makes them righteous. And like Roberts, the lawmakers who faced them down deserve kudos. Voters outside Sacramento have no idea what elected officials here have been through on this issue. Crazy doesn’t begin to describe it.
But it makes you wonder: What’s going on when we have to go to such lengths just to defend a principle as fundamental to civilized society as decent health care?