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How the ACA Could Collapse

Amity Shlaes:

Some time in the coming months, the Supreme Court will hand down its opinion in Sebelius v. Hobby Lobby, the case of the retailer that claims that its religious freedom or that of its employees is violated by contraceptive coverage required as part of the Affordable Care Act. The attitude of the health-care act’s supporters toward such cases is irritation. How dare a little religious case trip up the mighty Affordable Care Act and jeopardize the ACA’s establishment as permanent law of the land?

Cases involving religious details, however, do have a way of stopping big social legislation, and not only because they violate the principles of the religious denominations involved. Regardless of the Court’s decision, even pro-choice Jews, Unitarians, and Muslims may eventually change their views on the ACA precisely because of Hobby Lobby and cases like it.

To see how this might happen, it helps to go back to a case involving a commensurately ambitious piece of legislation, Franklin Roosevelt’s 1933 National Industrial Recovery Act.

The National Industrial Recovery Act, like the Affordable Care Act, aimed to do nothing less than change an entire sector of the economy — in that case, the industrial and business sector. After passage in 1933, NIRA created a bureaucracy labeled, in its turn, the National Recovery Administration, or NRA. NRA was hard to contradict: Its leader was a general; its emblem, the bald eagle. “Almighty God have mercy on anyone who attempts to trifle with that bird,” General Hugh Johnson told the public. The courts seemed to agree: Nine in ten NRA cases at first were decided in favor of the government.

NRA administrators led companies in the writing of codes for their respective trades. Like the ACA’s rules, these codes were offered in agonizing and counterintuitive detail. In those days NRA codes mandated minimum wages, minimum prices, new health and safety regulations, and business practices that efficiency experts recommended whether or not firms themselves saw their logic.

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