How can anything be both earth shattering-monumental, and unimportant-irrelevant? As everyone knows, SCOTUS (Supreme Court of the United States) will shortly announce its decision about the ACA (Patient Protection and Affordable Health Care Act of 2010). That decision will have profound policy implications regarding the reach and scope of Federal government. At the same time, it will have little impact on our daily lives in terms of health care.

The time to consider this paradox is before the decision is announced. Afterward, all anyone will talk about or even think about is political and financial effects, winners and losers, gamesmanship. Any thoughts about how the ACA will affect you, me, and our health care needs will be ignored in the score-keeping, especially various predictions about effects on the general election in November.

While we can do so, let’s consider how the SCOTUS decision on the ACA will impact Mr. and Mrs. Everyperson and their family in day-to-day activities.

Suppose SCOTUS strikes down the individual mandate*, that forces people to buy insurance and penalizes them if they do not. This takes away a large revenue stream from Washington. Otherwise, it changes nothing.

Striking down the individual mandate is the most likely course that SCOTUS might take on the grounds that the Federal government cannot force people to engage in commerce nor penalize them if they choose not engage in such commerce. (Please also note that buying health insurance is not an “interstate” activity. Indeed, competition by insurance companies across state lines is illegal.)

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