Obama’s health care dare

WASHINGTON — President Obama uttered more than 3,600 words on the stage of a hotel ballroom Tuesday, but his message could be summed up in three: You wouldn’t dare.

He was speaking not to the hundreds of hospital administrators assembled for the Catholic Health Association’s conference but to five men not there: the conservative justices of the Supreme Court, who by the end of the month will declare whether they are invalidating the most far-reaching legislation in at least a generation because of one vague clause tucked in its 2,000 pages.

Obama’s appeal to the justices, devotees of judicial modesty all: Do they really want to cause the massive societal upheaval that would come from killing a law that now is a routine part of American life?

“Five years in, what we are talking about is no longer just a law. It’s no longer just a theory. This isn’t even just about the Affordable Care Act or Obamacare,” he said. “This is now part of the fabric of how we care for one another. This is health care in America.”

Without mentioning the looming decision, Obama warned of its devastating potential. “Once you see millions of people having health care, once you see that all the bad things that were predicted didn’t happen, you’d think that it’d be time to move on,” he said. “It seems so cynical to want to take coverage away from millions of people, to take care away from the people who need it the most, to punish millions with higher costs of care and unravel what’s now been woven into the fabric of America.”

The appearance was scheduled long ago, but White House officials elevated the importance of the speech to keep pressure on the Supreme Court, which Obama said at a news conference Monday in Germany shouldn’t have even taken up the case. Obama said trashing the federal health care exchanges, as a hostile Supreme Court ruling would do, is “not something that should be done based on a twisted interpretation of four words.”

The conservative justices, like conservative critics of the law generally, are unlikely to be persuaded by Obama’s recitation of the merits of the law, which he repeated at length Tuesday. But they might well be reluctant to upend a law that now has broad acceptance in American society.

The Kaiser Family Foundation, which tracks public opinion on the matter, found in April that more Americans had a favorable view of the law (43 percent to 42 percent) for the first time since 2012. That difference is not statistically significant, but the favorable view is up 10 points since the botched HealthCare.gov rollout in 2013 and the unfavorable view is down seven points. Forty-six percent favor keeping the law as is, compared with 41 percent who favor scaling it back or repealing it.

More evidence of the acceptance of Obamacare: Gallup found last month that only 5 percent called it the country’s most important problem. That compares with 26 percent in September 2009.

Certainly, those numbers could change if premiums jump as expected. But the recent improvement in the law’s standing comes even though most Americans aren’t aware the law has cost the government less than forecast.

With such broad acceptance of (if not fondness for) the new health care status quo, it’s difficult to imagine the Supreme Court justices taking away health coverage for 6 million or 7 million Americans, causing costs to skyrocket for millions of others, and likely plunging the entire American health care system into chaos. That’s not just judicial activism — it would be a judicially induced cataclysm.

Such a cataclysm has no place in the catechism of Sister Carol Keehan, chief of the Catholic Health Association and a key early supporter of Obamacare, who broke with the Catholic bishops to support the law.

“It would be unspeakably cruel,” she said when I asked her after the conference what an adverse Supreme Court ruling would produce. Millions of people — pregnant women, cancer victims, heart patients — would lose coverage, she said. “The panic is going to spread, the confusion. It’s going to be incredibly chaotic.” And, with Congress unable to agree even on little things, the chaos would persist.

“It makes me crazy just to think of it,” Keehan said, urging me to “light a candle” as the justices prepare their opinion.

I’ll leave the votive offering to Sister Carol. I have faith the conservative justices, even if they detest Obamacare, have no desire to throw the country into chaos.

Dana Milbank is a columnist for The Washington Post whose work appears Mondays and Fridays. Email him at danamilbank@washpost.com.