The United States Supreme Court confirmed again that it is not going to clean up the mess Congress made with the Affordable Care Act. Now lawmakers and President Barack Obama must get to work.

For the second time, the court upheld a key provision of the act that, had it been stricken, would have destroyed Obamacare and thrown the nation's health care system into chaos.

The justices affirmed that federal health insurance subsidies for consumers in states that have not set up their own exchanges are constitutional. Opponents of the act had argued the language of the law as written by Congress limited subsidies to states that established exchanges from which their residents could shop for insurance.

Had the court gone the other way, subsidies for 6.4 million Americans, including 228,000 in Michigan — one of 34 states that did not set up an exchange — would have ended, breaking a private health insurance market rebuilt to comply with Obamacare.

In siding with the 6-3 majority, Chief Justice John Roberts noted, "Congress passed the ACA to improve health insurance markets, not to destroy them."

It's worth noting that Roberts refused to give the IRS prerogative to rewrite the law, eliminating the ability of a future president to effectively reverse the decision without congressional approval.

The chief justice also reminded that Congress, then controlled by Democrats, crafted the ACA behind closed doors and in a rush that worked against sound policy making.

Justice Antonin Scalia concurred, adding "this court has no free-floating power to rescue Congress from its drafting mistakes."

If the flaws in Obamacare are to be fixed, and there are many, Congress and the president will have to work together to fix them. Some of the solutions should be doable if the administration and lawmakers decide to cooperate.

One of the big problems with Obamacare is that it has resulted in a greater share of the cost of insurance transferring to individuals and families. It has spiked the cost of individually purchased coverage and triggered higher deductibles and co-pays for employer provided plans. Many smaller employers have dropped their insurance benefit and shifted workers to the exchanges.

To lower the impact on consumers, small businesses and individuals should be allowed to purchase insurance with pre-tax dollars. Refundable tax credits should be offered to lower income families and individuals enabling them to purchase policies.

To bring more competition and lower costs, the law should be changed to allow insurance to be sold across state lines. In several states, the number of insurance companies competing in the marketplace shrunk since Obamacare was implemented.

Health Savings Accounts should be expanded to help consumers pay the higher deductibles and co-pays. More flexibility is needed to provide relief from the coverage mandates of the act.

Finally, medical liability reform is necessary to keep frivolous lawsuits from driving up the cost of health insurance for everyone.

This law won't be mended by the courts. But it could be repaired by a Congress willing to stop fighting and start fixing.

Read or Share this story: