A thread on why the Supreme Court matters for anyone who believes in M4A or universal coverage. Obamacare was passed in 2010 with an individual mandate that penalized those who did not purchase insurance, a measure that forced states to expand Medicaid /1

(or else the states would lose their Medicaid funding), but no public option because of the opposition of a few conservative Democratic Senators, particularly Max Baucus of Montana. In 2012, the Supreme Court, by a vote of 5-4, upheld the law generally, but weakened /2

the Medicaid expansion, allowing states that choose not to expand to keep their Medicaid funding. Roberts was swing vote, voting with liberals to uphold the law but with the conservatives to weaken the expansion. In 2017, Congress eliminated the mandate, and now there is /3

an absurd case before the court (that Trump is supporting) that says that because the mandate no longer exists, the whole law must be unconstitutional. The case will almost certainly fail, but it shows that the administration is committed to ending the law. For those who /4

want M4A, it important to understand that the current court would effectively kill it. It would find that the elimination of a whole industry, private insurance, is a 'regulatory taking' meaning that the Fed gov would have to compensate insurance companies for their lost /5

business, and M4A would be prohibitively expensive. Roberts would certainly vote with the conservatives to declare M4A a 'regulatory taking.' A public option would hurt private insurers, and could in the long run ruin the private insurance industry, but Roberts would be /6

unlikely to strike it down. He would likely follow Penn Central v. NYC, where the Court distinguished regulations that eliminated the expected value of an investment and those that merely reduced it. So, in this formulation, eliminating private insurance would be a taking /7

but a public option, which has much less of an impact, would not. If Trump gets another term and the court gets more right wing justices, even a public option might be off the table. If anyone has any comments or criticisms of this thread, please let me know! /x