(5) The ACA discriminates against the young in favor of the old. Government policy already does this through payroll taxes that have young workers subsidizing Social Security and Medicare benefits. The ACA compounds the effect by forcing some young Americans to buy insurance at artificially high premiums that would pay for the care of a sicker, older population.

Cost control should have been Obama’s priority. He could have combined this with some of the ACA’s more modest and less controversial insurance expansions: providing additional federal coverage for poor children; keeping children on their parents’ policies until age 26; and establishing insurance exchanges in states to lower premiums for small businesses. But this restrained approach would have disappointed many liberals and denied Obama the presumed historical glory of achieving near-universal coverage.

To all the ACA’s substantive defects is now added a looming political and constitutional firestorm. Whether the Supreme Court upholds the whole law, strikes it all down or discards only parts, anger and outrage will ensue. The court may be accused of usurping legislative powers or of cowering before White House intimidation. The ACA has become an instrument of the political polarization that the president regularly deplores.