Dump The Individual Mandate
Howard Dean is (as he is often wont to do) making all kinds of sense on healthcare reform today. His idea is to jettison the "individual mandate" part of the healthcare reform law passed this year. And he's right, on both political and practical grounds.
The individual mandate is the least-liked part of healthcare reform. It really has no natural constituency other than insurance companies. There was no call from the public to include this in the final law (as there was with the "public option," in comparison). The Left wasn't in favor of it, and it causes apoplexy over on the Right. President Obama did not campaign on the individual mandate (although Hillary Clinton did, I should point out), so he obviously didn't think it was all that important (or all that good an idea, take your choice) before he got elected. Since the mandate appeared, very few people have bothered defending it in public. Its appearance in the debate was obviously a direct result of demands from the health insurance industry, who will be the obvious beneficiary of the plan.
But, as Howard Dean points out, healthcare reform can succeed without it. Which means there shouldn't be anything standing in the way of throwing the whole idea of the mandate under the political bus, so to speak. Or, since the Tea Partiers hate it too, perhaps "throw it overboard" would be a better metaphor.
Personally, I've never been a big fan of the mandate, although it likely wouldn't affect me in the near future. The idea of paying a fine, or extra taxes, because you can't afford health insurance doesn't exactly have a whole lot of support from anyone these days (again, other than insurance companies). In fact, several states are currently suing the federal government over the constitutionality of the law. The mandate was even put to a popular vote during the primary season, and it lost in a big way (around 70/30). Which means repealing it would be wildly popular, for either political party. Right now, Republicans are drooling at the chance of doing so, but that shouldn't stop Democrats from joining the effort. It's a little late for them to be "leading" the effort, but such a repeal would likely have wide and bipartisan support, so politicians of either stripe could benefit in the end.
Now, the mandate isn't slated to go into effect for another few years. Repealing it would have no immediate impact on the status of health insurance. It would impact the future projections of healthcare, but the only ones who would be screaming about this would be, once again, the insurance companies. But, this time around, they're not going to find a whole lot of politicians willing to champion their position. Especially since the push to repeal it is coming from the Right in the first place. Republicans would be faced with the choice of parroting the insurers' talking points and carrying the legislative water for the industry (as they did in the whole healthcare reform battle over the past year and a half) -- or jumping on the "Repeal!" bandwagon wholeheartedly. This seems to be a no-brainer for them, since a large segment of the folks advocating repealing the mandate are from the Republican rank and file. And Republicans have already burned their fingers on a few hot teakettles this election season, meaning they would likely be very wary of siding with the insurers against their own political base's voters.
Democrats should also realize that defending the mandate is a losing battle for them as well. The mandate, as I said, is the least popular part of the healthcare law they managed to pass. It is the biggest target for those who are against the new law. But while Republicans seem to be dedicated to repealing the entire healthcare reform law (either as a whole, or bit by bit), Democrats could yank the rug out from under the GOP by getting rid of what is seen as the worst part of it, pre-emptively.
The other parts of the new law are a lot less contentious, and benefit families directly. By removing the mandate as the focal point of the opposition, it would force them to attack the other parts of the law instead. And while the Republicans have been making lots of political hay over the mandate issue, it's going to be a lot harder for them to do so on the issues of, for example, getting rid of the concept of pre-existing conditions or letting children stay on their parents' policy until they're 26. Neither of these has been put to a popular vote anywhere yet, but I would be willing to bet that they're a lot more popular with the public than the mandate.
Getting rid of the mandate would remove it as an issue from the debate. It would end the ongoing court cases. It would end the talk of constitutionality by healthcare reform critics. It would focus the debate on the parts of the new law that are much more popular. And even Howard Dean is now arguing that doing away with the mandate doesn't mean the rest of the law won't be successful. The insurance companies would howl, but this time their legislative lapdogs on the Right will be much more concerned with saving their own political skins than with placating the insurers.
Of course, repealing the mandate is not going to happen before the midterm elections. The legislative calendar is just too short. It might be brought up as an issue in the political arena before the elections, but it isn't going to make any legislative progress until afterwards. Democrats might not be inclined to vote for repeal in the next Congress, because the effort will be seen as a Republican one, and Democrats would likely not be happy about "giving the Republicans a political victory." Also, there is the bunker mentality which says the issue is the start of a slippery slope of repealing the entire healthcare law. Democrats may adopt a "circle the wagons" defense of the whole bill, and fight the repeal of the mandate tooth and nail. This would be a mistake, as I see it.
President Obama would also face a choice, if Congress passed a mandate repeal and put it on his desk. No matter what happens in the midterms (no matter which party holds which houses, in other words), he's still going to have enough Democrats in both houses to sustain his vetoes. Meaning he could fight hard for the mandate, and veto any repeal which crosses his desk. This would also be a mistake, as I see it.
Of course, Obama and the rest of the Democrats would have to eat a little political crow during the repeal effort. They'd have to essentially admit "we were wrong about this part," which is never easy for a politician to do. But, in the end, they would benefit politically by going along with the Republicans on a limited basis -- repealing the mandate, not repealing the entire law. Man the barricades and fight for the rest of it, in other words, but dump the mandate part with grace.
No one issue in the healthcare law which actually exists in reality (unlike, say, "death panels") has galvanized the opposition to such a degree. And this opposition is winning the argument in the public arena. The individual mandate has no natural constituency behind it other than the insurance companies themselves. Outside the Beltway, Republicans hate it, independents don't like it, and (at best) Democrats are lukewarm on it. Getting rid of the mandate won't kill the entire healthcare reform law. I hate to say it, but the Right is right on this issue. Jettisoning the mandate is a good idea politically, and the Democrats should realize it and get behind it themselves. It removes a potent issue from the political debate (and from the courts), leaving behind much better issues for Democrats to draw lines in the sand on (again, like eliminating "pre-existing conditions"). Democrats have a choice -- they can either throw their support behind the issue, or wait until after the elections and watch the Republicans talk about it for approximately the next six or seven months, before they repeal it without Democratic help. Getting on board sooner is the smart thing to do in this case.
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant
It's probably a good idea to drop the mandate before it's declared unconstitutional by the courts.
Unfortunately, it's a LOSE LOSE situation for Obama and the Democrats.
Drop the mandate and the administration has to admit it dropped the ball.
Don't drop the mandate and have the courts whack the administration's wee-wee..
Personally, I don't think that the administration will drop the mandate. Obama has a real problem with admitting he was wrong and owning up to his mistakes.
If Obama does drop the mandate, I am sure he will spin it so that it was all Bush's fault.. :D
Michale.....
"President Obama did not campaign on the individual mandate (although Hillary Clinton did, I should point out), so he obviously didn't think it was all that important (or all that good an idea, take your choice) before he got elected."
I think the word you're looking for is "popular": he didn't campaign on it, so he obviously didn't think it was all that popular.
"The idea of paying a fine, or extra taxes, because you can't afford health insurance doesn't exactly have a whole lot of support"
If you can't afford it because you have too little income, the government should pay for it. (If we're going to have insurance-based medical care at all, anyway.) And they do, under the law. If you can't afford it because you spent the money on something else, like a house that's worth a million dollars solely because you think you can sell it to someone else for more than that later, maybe there should be an incentive against that kind of "can't afford it". If that's why you "can't afford it", maybe the government shouldn't be stuck with the medical bills.
"It would end the talk of constitutionality by healthcare reform critics."
Pull the other one. It has bells on.
--
All that being said, I'm not particularly committed to the individual mandate. Theoretically there are good reasons for it. But the situation is complicated enough that empirical answers are needed.
Politically, it was absolutely necessary in order to keep the insurance companies from killing the whole thing. There's something to be said for keeping one's end of an agreement: if the insurance companies get burned for having made a deal, the next interest group with veto power will could understandably think it safer to just say no.
Democrats might not be inclined to vote for repeal in the next Congress, because the effort will be seen as a Republican one, and Democrats would likely not be happy about "giving the Republicans a political victory."
In other words, the Democrats are "The Party Of 'NO'"... :D
Ya gotta love the irony... :D
Michale.....
Interesting, CW. To me, the important thing here is that the conversation needs to be shifted from "repealing" to "fixing" healthcare legislation.
That's why I find your suggestion interesting. I had a feeling that individual mandate was going to be a "poison pill" in the legislation.
-David
P.s. Someone, forget who, had an interesting article over at Salon arguing that it might not be a bad thing to have a Republican Congress. Why?
1) Republicans could no longer play the "we're not in power" card
2) Republicans would actually have to take some responsibility for what gets accomplished or not accomplished, rather than just saying "no"
Basically, there would be more incentive for them to negotiate.
Still hoping for a comeback in November if Dems can get out the vote, but it might not be the end of the world if Republicans win in November :)
1) Republicans could no longer play the "we're not in power" card
2) Republicans would actually have to take some responsibility for what gets accomplished or not accomplished, rather than just saying "no"
Republicans never had a problem doing that when they were in power..
So, what you are saying is that the political roles will be reversed.
The GOP will be full steam ahead over their agenda and the Democrats will become the party of NO...
Of course, if recent history is any guide, the Democrats will actually become the party of "Maybe, oh all right, fine! Do what you want!!" :D
Michale....
Now for a little comic relief.. :D
http://www.foxnews.com/static/managed/img/Opinion/11ToddRoberts.logo.jpg
Michale.....
Republicans never had a problem doing that when they were in power.
LOL. Republicans? The party of "personal responsibility"? Looks more to me like they've spent the last 2 years trying to blame everything on Obama.
But I could just be basing that on what they've said. Comic relief indeed.
LOL. Republicans? The party of "personal responsibility"? Looks more to me like they've spent the last 2 years trying to blame everything on Obama.
There are a couple reasons for that..
A. They have been the MINORITY party...
and
2. Everything, pretty much, IS Obama's fault... :D
Ok, maybe not everything. But a lot of it is his fault..
But does he take responsibility for that??
Nope...
It's always "Bush's" fault... Or "Congress'" fault.. Or the "People's" fault..
Never Obama's fault...
November 2nd can't come soon enough...
Michale.....
A. They have been the MINORITY party.
Not sure when the minority party's role became endless moaning and blaming, but ok.
This speaks to what I said earlier. If Republicans win Congress then they might actually have to take some responsibility. They won't always be able to say "no".
Not sure when the minority party's role became endless moaning and blaming, but ok.
BTW- That said. I do realize that they are trying to define themselves and that there's only so much they can do as minority party.
I just wish they would focus on what they do better and I also wish that they would pick their battles - rather than say "no" to everything. Health care, for example, is a winning one for them.
This, to me, hurts their credibility and gives credence to the "party of no" label.
Not sure when the minority party's role became endless moaning and blaming, but ok.
I think it started in 1994... :D
This speaks to what I said earlier. If Republicans win Congress then they might actually have to take some responsibility. They won't always be able to say "no".
And my point was that, when the Republicans WERE the majority, they DID take responsibility. And then it was the Democrats who always tried to say no...
I just wish they would focus on what they do better and I also wish that they would pick their battles - rather than say "no" to everything. Health care, for example, is a winning one for them.
By definition, Political Partys care about their Party first and their country and obligations second.
This is, by NO means, solely the fallibility of the Right...
Michale.....
Michale -
I know this is a comment on another thread, but I'm rushed, so excuse the disjointed nature.
DREAM Act article (you're basically right, except that it's just 2 years in military or in college), which explains it in a novel way:
http://www.salon.com/news/politics/war_room/2010/09/22/tea_party_dream_act/index.html
-CW
CW,
Thanx for the link...
Yea, the DREAM Act is a WIN WIN WIN for everyone across the board..
I don't know WHAT the GOP was thinking when they opposed this..
I bet that if it was offerred up on it's own merits without any baggage, it would be VERY well received..
But it today's hyper-partisan environment, it won't ever see the light of day.
Which is a shame.
Michale.....
Thanks CW & Michale. I hadn't seen or heard much on the DREAM Act in the lamestream media.
It does seem like something just about everyone could agree upon. Everyone, that is, except politicians.
Sad ...
David
Howard Dean is (as he is often wont to do) making all kinds of sense on healthcare reform today. His idea is to jettison the "individual mandate" part of the healthcare reform law passed this year. And he's right, on both political and practical grounds.
So how come the party of "no" was wrong when they spoke out against it, and warned against it, and voted against it?
The individual mandate is the least-liked part of healthcare reform. It really has no natural constituency other than insurance companies. There was no call from the public to include this in the final law (as there was with the "public option," in comparison). The Left wasn't in favor of it, and it causes apoplexy over on the Right. President Obama did not campaign on the individual mandate (although Hillary Clinton did, I should point out), so he obviously didn't think it was all that important (or all that good an idea, take your choice) before he got elected.
So how come the mandate is there and the public option is gone? Because Insurance lobbyist Karen Ignagni insisted that Obama ditch the public option he had promised to deliver to the American people and give her what she was demanding, instead. And he did. "That was the quid pro quo," as Tom Daschle says in the PBS Frontline documentary, "Obama's Deal."
Remember when Pelosi said, "We have to pass CrapCare to know what's in it"...
Well, she KNEW what was in it and she KNEW that the people would be even MORE against it if THEY knew what was in it..
So, let's look at CrapCare, 6 months later..
» Obamacare won't decrease health care costs for the government. According to Medicare's actuary, it will increase costs. The same is likely to happen for privately funded health care.
» As written, Obamacare covers elective abortions, contrary to Obama's promise that it wouldn't. This means that tax dollars will be used to pay for a procedure millions of Americans across the political spectrum view as immoral. Supposedly, the Department of Health and Human Services will bar abortion coverage with new regulations but these will likely be tied up for years in litigation, and in the end may not survive the court challenge.
» Obamacare won't allow employees or most small businesses to keep the coverage they have and like. By Obama's estimates, as many as 69 percent of employees, 80 percent of small businesses, and 64 percent of large businesses will be forced to change coverage, probably to more expensive plans.
» Obamacare will increase insurance premiums -- in some places, it already has. Insurers, suddenly forced to cover clients' children until age 26, have little choice but to raise premiums, and they attribute to Obamacare's mandates a 1 to 9 percent increase. Obama's only method of preventing massive rate increases so far has been to threaten insurers.
» Obamacare will force seasonal employers -- especially the ski and amusement park industries -- to pay huge fines, cut hours, or lay off employees.
» Obamacare forces states to guarantee not only payment but also treatment for indigent Medicaid patients. With many doctors now refusing to take Medicaid (because they lose money doing so), cash-strapped states could be sued and ordered to increase reimbursement rates beyond their means.
» Obamacare imposes a huge nonmedical tax compliance burden on small business. It will require them to mail IRS 1099 tax forms to every vendor from whom they make purchases of more than $600 in a year, with duplicate forms going to the Internal Revenue Service. Like so much else in the 2,500-page bill, our senators and representatives were apparently unaware of this when they passed the measure.
» Obamacare allows the IRS to confiscate part or all of your tax refund if you do not purchase a qualified insurance plan. The bill funds 16,000 new IRS agents to make sure Americans stay in line.
http://www.washingtonexaminer.com/opinion/Obamacare-is-even-worse-than-critics-thought-960772-103571664.html#ixzz10NljlEkp
No wonder Democrats don't want to brag about CrapCare....
Michale.....
in theory, there's nothing wrong with a mandate. if there were a public option and better cost control measures, it would be a good idea. constitutional arguments aside, a mandate without those other things is just plain silly. many people will be unable to afford the mandated coverage, essentially making healthcare a form of backdoor taxation.
CW said at the time of HCR's passage that the main thing at the time was to get a few good things passed (such as the ban on "pre-existing condition" rejections), with the intention of fixing the problem areas afterward. but as michale has pointed out on numerous occasions, the hcr legislation in its current form has very little of what people want, and a whole lot of what they don't. personally, i'd prefer to have a mandate (unpopular) with a public option (popular), as well as government-enforced price controls (un-polled, but i bet they'd be popular) on the cost of certain drugs, doctor visits and insurance coverages.
that's a more economically liberal view on the issue than Congress might be comfortable with, but at least it's coherent. then again, as CW's latest column proves, neither D's nor R's seem to be all that good at math. in any case, this is a squish like grape issue. (can i trademark the expression? i think i was discussing hcr the first time i used it, too.) for those to whom i have not yet quoted the famous line from the karate kid:
Daniel-san, must talk. Walk on road, hm? Walk left side, safe. Walk right side, safe. Walk middle, sooner or later get squish, just like grape.
Wanna see something interesting? This poll came out on Wednesday, March 24th, after "the Senate version of the legislation was passed by the House Sunday night, and President Obama signed it into law on Tuesday":
Should Republicans continue to challenge the Health Care Bill?
Yes - 62%
No - 33%
http://www.cbsnews.com/8301-503544_162-20001117-503544.html
And according to Rasmussen's latest Likely Voters poll...
61% Favor Repeal of Health Care Law
[excerpt] ... A new Rasmussen Reports national telephone survey finds that 33% of Likely Voters oppose repeal...
How's that for consistency?