The Economist March 24th 2012

United States; 51

Obamacare at two

Heal thyself
"EWVOR ~

No matter what happens to Saraek Obama's Jaw, American health care is changing rorgood "HELEN R. ~ is an elderly woman who is currendy on seven different medications. Thanks to Barack Ohama's health reforms, however, she gets cheaper medicine and cancer tests. "The health-care law is about people like me," Helen R. explains in a new video on a government website. Republicans may deride the health law as "Obamacare." Helen R. prefers to call it "Helencare". Mr Obama's health reform turned two years old on March 23rd. The White House is doing ils best to sell it as a success. The video of Helen R. is one of many. The Department of Health and Human Services (HHS) releases sunny data almost daily. But the campaign still feels defensive. There are good reasons for that: the law's main provisions will not take effect until 2014, and this anniversary may be its last. Republicans in Congress and on the campaign trail say they will scrap the law at the first opportunity. With an election in November that threat is now real. A more immediate danger looms on March 26th when the fight over the law will reach the Supreme Court. The main question is whether Congress may penalise those who do not buy health insurance, the so-called "individual mandate". But the COUri will consider other questions, too: whether the law coerces states to expand Medicaid; whether the rest of the law can stand if the mandate is struck down; and even whether the whole case should be postponed until the mandate takes effect in 2014. Big rallies will coincide with the Supreme Court's argu· ments, but the furore belies an increasingly obvious fact. American health care is changing, possibly for good. thaI is nOl because the law's implementation has been smooth. In October Mr Obama scrapped an impractical