Supreme Court’s health-care decision to shape presidential campaign, says WUSTL health economist

The Supreme Court’s ruling on the Affordable Care Act (ACA) will have a major impact on the presidential campaign, says Timothy D. McBride, PhD, health economist and associate dean for public health at the Brown School at Washington University in St. Louis.


“The health reform legislation was the signature piece of social legislation passed by President (Barack) Obama’s administration in his first term,” he says.

The court began hearing arguments in the case March 26. How its decision will influence the election could be quite complex, says McBride.

“If the court upholds the legislation, then the administration will herald this as a major victory and state that this as a major accomplishment, putting an exclamation point on their signature legislative accomplishment.

“On the other hand, if the court strikes down the ACA, on the surface this could be seen as a major blow to the administration, and a huge boost to the Republicans, who have argued for repeal of the whole legislation,” McBride says.

McBride notes that the administration asked for the Supreme Court to consider the ACA before the election.

“This surprised me, but I can see the strategy,” he says.

“If the court strikes down the ACA, the Obama administration can make it a campaign issue to rally their base and argue it is imperative to re-elect the President to stave off the attack on health reform.”

McBride says this case, in which the major issues are the individual mandate to purchase health insurance and the expansion of Medicaid, is widely anticipated because the challenges to health reform have largely halted the legislation’s implementation in many of the states.