The Obama administration maintains that its Affordable Care Act is a complex construct that's endangered if the Supreme Court finds its central feature -- the requirement that all Americans buy health insurance -- unconstitutional. It's certainly true that eliminating the "individual mandate" will immediately expose the plan as unworkable. It can only succeed by creating a broad, universal insurance pool that collects big premiums from the young and healthy. If the young and healthy aren't required to sign on, they won't. Hence, the pools won't be remotely large enough to pay for the older, sicker folks who get the best deal, and are bound to flock to the state exchanges.

In reality, the reform plan's success doesn't depend on the Supreme Court's decision at all. Its faulty design virtually guarantees that all the things the administration warns will happen if it loses will happen anyway. Even if it stands, the legislation will spawn insurance plans crowded with high-cost folks, driving premiums higher, hobbling competition as carriers abandon the exchanges, and leaving tens of millions of Americans uninsured.

When Congress created Medicare Part D, the created two benefits for seniors. The first is a basic benefit where seniors pay 25% of their annual drug costs up to $2,830 (in 2010) and the government pays the rest. The second is a catastrophic benefit where the government will pay 95% of a senior's drug cost above $6,440. In the middle (from $2,830 to $6,440), seniors are responsible for 100% of the costs. The benefit to taxpayers is that the gap between the two benefit programs (critics call it the "donut hole") is that it incentivizes seniors to opt for generics to avoid the so-called donut hole. ObamaCare eliminates the donut hole and in turn one of the most important market-based aspects of Part D.

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