The constitutionality of the individual mandate is now the subject of debate in the Supreme Court. Barack Obama decided his legacy would be universal health care, even if it was an intrusion into personal freedom and simply unconstitutional. Remember, this is the man touted as a constitutional scholar as he ran for the highest office in the land. No one bothered to notice the egotism of the man, though.
So the laudable goal of universal coverage ought to be balanced against drawbacks. At the margin, the ACA will probably discourage job creation, because mandated insurance raises the cost of hiring and the complexity of the 2,700-page law will intimidate some employers. Requiring younger workers to have expensive, comprehensive insurance (as opposed to catastrophic coverage) expands the undesirable inter-generational transfer from them to their wealthier elders. Finally, the ACA worsens the budget outlook.
The Obama administration has obscured this by arguing the program reduces budget deficits. Though technically true, this is misleading.
Considering the ACA's glaring -- and predictable -- economic and political shortcomings, why did Obama make it his first-term centerpiece? The answer seems to be his obsession with securing his legacy as the president who achieved the liberal grail of universal coverage. In his book "The Escape Artists: How Obama's Team Fumbled the Recovery," Noam Scheiber recounts a telling incident. Obama's advisers tell him he can be known for preventing a second Great Depression. "That's not enough for me," Obama replies.
The ACA is Obama's ego trip, but as a path to presidential greatness, it may disappoint no matter how the court decides. Lyndon's Johnson's creation of Medicare and Medicaid was larger, and he isn't deemed great. And then, unlike now, government seemed capable of paying for bigger programs.
How sad that 1/6 of our nation's economy will be compromised if one man's attempt at a grand legacy pans out.