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Let the games begin

Signing historic health care reform is just the start



Only moments before I began writing this column President Barack Obama signed the much-vaunted health care bill into law. Seven minutes later, attorneys general from 13 states filed suit to halt what they contend is the measure's unconstitutional mandate, which forces individuals to buy health insurance. The flood of competing sound bites aside, the bill's passage is obviously not the end of a health care debate that has raged for more than a year already. In fact, the games have just begun.

You'd have to be living in a cave not to notice the total euphoria being beamed across the planet by the White House and congressional Democrats over the narrow passage of the Senate version of the health care bill. If you take the press statements at face value, which is kind of hard to do if you know anything about the bill, this is the greatest thing since, well, since just about forever. At least that's the take coming from the Democrats who, after all, were the only ones to vote for the measure (and not even all of them did that).

If you give the other perspective any credence, the picture is quite a bit different. Republicans say it will bust the budget, criminalize those who don't want to buy health insurance, take away our health care choices, and eventually result in government deciding who gets what in the way of care. The "Don't Tread on Me" Tea Party says all that and more.

As usual in the big game of politics these days, the truth of the matter lies somewhere in between the jubilation, obfuscation and exaggeration being spewed by the partisan players.

In the meantime, while the Democrats are dancing in the streets and the Republicans are sharpening their sabers, considerably less attention is being paid to the "fixes" that are included in legislation the House just passed over to the Senate. And yeah, you'd be correct to ask: "If the bill is so great, how come it needs fixes already?"

The answer is that the measure wouldn't have passed if the House Democrats didn't get some assurance that the "fixes" to the Senate bill would be enacted. While the promises have been made, it's prudent to remember that had the Senate wanted those "fixes" in their bill, they could have included them originally, but did not—at least the provisions that actually apply to health care. The other add-ons that were tossed in to make the bill more palatable to the House—like putting student loans back in the hands of the government and out of the rapacious banks—are what the Senate will have to accept as part and parcel of the bargaining it took to get their fellow Democrats to vote for the bill. As the Senate moves quickly to take action on the fixes in the face of fierce Republican opposition, we'll soon see how this part of the soap opera turns out.

The reality, however, is that whatever happens in Washington, D.C., from now on is only part of the on-going health care game. The attorneys general from 13 states have already filed their suits. That means more than a quarter of all states in the nation are opposing the bill before the ink of Obama's signature has even dried. Nor is that the end of it since more than 30 states have already requested or introduced legislative measures to allow them to ignore the provisions of the health care bill. Plus, there are efforts already underway to amend state constitutions to specifically reject the federal mandate that individuals must purchase health insurance.

Few can doubt that the rising tide of angst, anger and action against the bill is worth noting. Even fewer can doubt that those lawsuits by the states will ultimately wind up before the U.S. Supreme Court after endless and costly court battles and appeals—all of which will be paid for by, you guessed it, state and federal taxpayers. When states battle the federal government, it's "We, the People" who get to pick up the tab, no matter who wins in the end.

At this point it's impossible to foretell what the outcome will be, but some things seem certain: If the states prevail, and the Supreme Court rules that the federal government does not have specific authority to mandate the purchase of a product (insurance) by individuals, the great health care bill quickly unravels. Without the mandated growth to the corporate insurance pool of some 32 million new customers, all those other provisions, like forcing insurance companies to provide coverage despite pre-existing conditions, won't work—they'll simply lead to claims that the government is bankrupting them and the fat backroom deal they cut with Obama and the Dems won't be much of a deal for them anymore.

If, on the other hand, the states don't win their suits, the power of the federal government to control states and individuals will have taken a giant leap forward, albeit in what many would consider the wrong direction. In politics, just as in physics, every action has an equal and opposite reaction, and you can bet that the reaction will be a nationwide effort to reverse the power grab by the feds through yet more lawsuits, more state constitutional changes and, if things get really out of hand and people get angry enough, by civil disobedience and riots like we haven't seen since the civil rights and Vietnam War clashes of the '60s. And believe me, having lived through those times, it won't be much fun.

For now, though, the Dems are dancing in the streets, insurance and health cartel stocks are soaring (which should tell you something about what a great deal this bill is for the populace), and the seething anger boils away. Far from unifying the nation, on health care and its relation to states' rights and partisan politics, the game has just begun.

Helena's George Ochenski rattles the cage of the political establishment as a political analyst for the Independent. Contact Ochenski at

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