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It's Either Obamacare or Bust

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English: President Barack Obama's signature on...

By Bob Cesca: It's very unlikely the president will offer up a new healthcare reform bill if the current law is ripped to shreds by the conservative-controlled Supreme Court. In his own words, there are only two ways to make sure all Americans can afford healthcare: the current law or "a single-payer system like Medicare." And there's just no way the president will begin his would-be second term with an effort to pass a single-payer government-run health insurance system.

In case you don't remember, the first time around was harrowing enough. It lasted for the better part of a year and Americans went apeshit crazy. Prior to the healthcare reform process, Americans supported reform and universal care by overwhelming margins. But as soon as a Democratic president tried to actually do something about it, everyone went crazy with red scare McCarthy era rantings about socialism and death panels.

In 2007, Americans came remarkably close to supporting a complete replacement of the current healthcare system with a British-style government-run system. 41 percent supported this while 48 percent opposed it. An overwhelming 69 percent of Americans said that it was the government's responsibility to make sure everyone can receive healthcare coverage. Once 2009 rolled around, that number dropped to 47 percent. Nevertheless, the public option, as a facet of the healthcare reform bill was tremendously popular -- and rightfully so.

Everyone was confused about the congressional process. Far-right conservatives didn't know that Medicare was a government-run program. Liberals were sharply divided over the bill with some joining the ranks of the far-right to "kill the bill." The public option was a zombie provision -- dying then resurrecting then dying again. The no-brainer items in the bill, like providing coverage for end-of-life counseling without co-pays or deductibles, became a horror movie meat grinder into which President Obama was personally feeding old people. When the president delivered an address to a joint session of Congress, Rep. Joe Wilson (R-SC) shouted "You lie!" when the president reassured the lawmakers that illegal immigrants weren't covered in the bill -- a bill which they themselves were authoring.

To this day, very few people even know what was in the bill. It's a shame, too, because I imagine that if people knew what kind of benefits they'll be receiving from the legislation, they'd think twice before shrugging it off. For a second, put aside all of the new rules in the ACA that prevent health insurance companies from screwing us and think about this. Families of four earning around $55,000 per year will likely pay an additional $6,597 in annual premiums without the Affordable Care Act's premium caps, and they will lose an additional $1,930 in annual subsidies to help them pay for insurance. In total, these families will pay an additional $8,527 per year for health insurance if the ACA is overturned by the Supreme Court. Fact. And that includes Republican families.

From a purely bottom-line point of view, "Obamacare" will save you a lot of money.

That's in addition to the dozens of other benefits in the plan, from preventing an insurance company from taking away your coverage when you get sick or injured, to ending lifetime limits on coverage, to allowing preventative medicine without co-pays or deductibles, to closing the Medicare Part-D donut-hole, and so on and so on.

It was a massively difficult fight, and one that could only have been successful at that moment in time. And to start from scratch with the exact same bill would be almost too daunting to imagine -- especially with a Republican-controlled House.

Now imagine pushing a single-payer bill. Such a plan would involve disbanding all private insurance companies and expanding Medicare to include everyone from cradle-to-grave. It's never going to happen -- at least not for another decade or two, and only then as a amendment to the existing ACA. If the current law is struck down by the Supreme Court, the entire effort will start from zero, and those of us old enough to remember 2009 will agree that such a prospect takes one's breath away. On the other hand, if the law is upheld, progressives ought to immediately mobilize in support of a public option bill or an expansion of the Medicare eligibility age.

So it's either "Obamacare" or a financial burden on families (not to mention the federal budget deficit and national debt) that will make it impossible to afford healthcare. At all. This is what's at stake. Even without the inclusion of a public option, dozens of problems were solved with this one hard-fought law, and if Justice Kennedy swings in support of the conservative justices, all of those solutions will be unraveled at the significant expense of the American people irrespective of party and ideology.

And, no. Single-payer or a public option will not replace it.

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