By Steve Brawner, © 2018 by Steve Brawner Communications, Inc.

How significant was the federal judge’s ruling last week that Obamacare is unconstitutional? We might not know for another two years, but the bigger question is, what happens in the next 20?

The judge ruled in a lawsuit that the Affordable Care Act (ACA) is unconstitutional because the U.S. Supreme Court’s original reasoning could no longer stand.

Back in 2013, the Supremes ruled the individual mandate to buy health insurance is constitutional because the penalty for not doing so is a “tax.”

In December, Congress repealed the penalty when it passed the Tax Cut and Jobs Act. A Texas-led coalition of 20 states, including Arkansas under Attorney General Leslie Rutledge, sued arguing that without the penalty, there’s no tax, which means Obamacare itself is no longer constitutional.

Texas Judge Reed O’Connor agreed, though he did not issue an injunction, which means nothing happens while the ruling is under appeal. Now the case winds its way through the system, perhaps ending at the Supreme Court.

So now … is it business as usual, while we wait a couple of years? Pretty much, at least according to President Trump’s own administration. While he was trumpeting the ruling, his Centers for Medicare and Medicaid Services administrator, Seema Verna, was reassuring the public that nothing has changed yet. The ruling does add another layer of uncertainty, and business hates that.

Gov. Asa Hutchinson always has been in an awkward place regarding Obamacare. He has always said he opposes it, but he also depends on it.

First, since the ACA was passed, Arkansas’ uninsured population has dropped from 16 percent of the state in 2013 to 7.9 percent in 2017, according to the Census Bureau. On the other hand, insurance rates have risen, as they did before.

The law reduced the uninsured population partly because it banned the awful practice of denying coverage for pre-existing conditions.

The bigger contributor was the Arkansas Works program. Created during Gov. Mike Beebe’s administration, it buys private insurance for more than 234,000 lower-income Arkansans. It is a result of the ACA and is funded mostly by the (debt-ridden) federal government. Hutchinson has embraced it, with some changes. Without it, hospitals would provide more uncompensated care, and some likely would have closed. It’s happened in other states.

In addition to providing health insurance for 234,000 people, Arkansas Works has reduced costs for people (like me) who buy their own insurance. In Arkansas, unlike in some other states, three big insurance companies compete against each other. They stayed here because they knew they would have a big market through Arkansas Works with more young, healthy individuals in the pool.

Finally, those billions of federal dollars flowing into the state through Arkansas Works have allowed Hutchinson to cut taxes twice and will allow him to propose more tax cuts in 2019.

Many of Obamacare’s opponents call it socialism. That’s not accurate.

Obamacare’s big failing is that it didn’t solve the health care system’s long-standing, fundamental problems, including that it incentivizes the wrong things – among them, care rather than cures. For that reason and others, health care is 18 percent of the gross domestic product – far more than the rest of the civilized world.

That’s not sustainable, with or without Obamacare. Eventually, something will change. We’ll either fix this the right way, or there’s going to be a train wreck. And then maybe we’ll fix it and maybe we won’t.

Hutchinson wants more flexibility for states. After the ruling, Rutledge released a statement saying, “Now, it is time for Congress to increase options, lower costs and protect those with pre-existing conditions.”

That would be nice. Two questions. First, how? And second, does anyone think that’s going to happen now that Democrats control the House while Republicans control the Senate and the White House?

Not for another two years, that’s for sure. But maybe sometime in the next 20.