Cost control should have been Obama's priority. He could have combined this with some of the ACA's more modest and less controversial insurance expansions: providing additional federal coverage for poor children; keeping children on their parents' policies until age 26; and establishing insurance exchanges in states to lower premiums for small businesses. But this restrained approach would have disappointed many liberals and denied Obama the presumed historical glory of achieving near-universal coverage.
To all the ACA's substantive defects is now added a looming political and constitutional firestorm. Whether the Supreme Court upholds the whole law, strikes it all down or discards only parts, anger and outrage will ensue. The court may be accused of usurping legislative powers or of cowering before White House intimidation. The ACA has become an instrument of the political polarization that the president regularly deplores.
When historians examine Obama's first term, the irony will be plain. A president bent on burnishing his legacy acted in ways that did the opposite. It's a case of bad judgment.
Robert J. Samuelson is a Washington Post columnist.
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