individual mandate


Obamacare's Mandate Meltdown

Jeffrey Anderson and I have a column in the New York Post on why the individual mandate is unlikely to persuade Americans to buy into the Obamacare exchanges.

The ObamaCare law thus made insurance a less valuable product for most people, even as it pushed up the cost of buying it.

The coercion of the individual mandate was supposed to balance the equation, but it’s far too weak to do so — and it’s getting weaker each time the administration proclaims another exemption.

You can read the rest of the column here.

 

posted by James C. Capretta | 2:50 pm
Tags: individual mandate, Jeffrey Anderson
File As: Health Care

The Enduring Myth of the Individual ‘Mandate’

Supporters of the Affordable Care Act have always had a difficult time talking about the “individual mandate,” since it is at the same time the most strikingly coercive and heavy-handed element of the law while also being essential for making the law work. As I argue in a column at National Review Online, however, the Supreme Court's decision last June to uphold Obamacare also undermined the legal and moral force of the “mandate” by ruling that it was only legitimate if understood as an optional tax on the uninsured, not a legal mandate obligating citizens to purchase health insurance.  

Though the law’s supporters believe the threat of the mandate is critical to forcing people into the Obamacare exchanges, they don’t want to admit this directly to voters. So the mandate is mentioned often in policy circles, but seldom by supporters when communicating in the media or directly to voters. Every once in a while, though, when pressed in more public settings on why they think the young will sign up for coverage, they are forced to admit that it’s due in part to their faith in the mandate — as Zeke Emanuel did on Fox News Sunday over the weekend.


The ambivalent embrace of the mandate by Obamacare’s authors is reflected in the law’s construction. Initially, the mandate’s year-by-year penalties were set at much higher levels, but they were lowered by Democrats on the Senate Finance Committee to protect themselves from political attacks by Republicans. As enacted, the mandate’s penalties are very low, especially relative to the premiums charged by insurers in the exchanges, and especially in the first two years. In 2014, the penalty, or tax, is the greater of (a) a per-person tax of $95 per adult and $47.50 per child, up to a maximum of $285, or (b) 1 percent of total household income. The tax rises to 2 percent of household income in 2015. A typical household of four people with an income of $40,000 will face a mandate tax of $400 in 2014. That compares with premium payments of $1,500 to $3,000 for the typical low-cost insurance offerings, even after the federal subsidies are netted out of the premium costs.

You can read the rest of the column here.

posted by James C. Capretta | 11:45 am
Tags: individual mandate, Supreme Court
File As: Health Care

Keeping the Pressure on Obamacare

The disastrous implementation of the Obamacare health insurance exchanges on October 1 has left the left health care law more vulnerable than ever. As I argue in a column at National Review Online, Republicans need to continue to push back against the most problematic and unpopular elements of the legislation to both protect Americans losing their insurance because of Obamacare, and to hasten the eventual repeal and replacement of the law with a better alternative.

The first order of business remains thinking through what to do about canceled individual-market policies. Prior to last week, it would have been unthinkable that the White House would unilaterally adopt a policy allowing millions of people to stay in their individual-insurance plans in 2014. After all, notwithstanding that famous presidential pledge, a major focus of Obamacare is the termination of the individual insurance market and the shifting of that market’s participants into the Obamacare exchanges in 2014. An escape route that allows large numbers of current individual-insurance enrollees to avoid the exchanges in 2014 (even one with its own set of traps) raises the very real possibility that the exchanges will falter before they ever get started.

This does not mean that the GOP should be applauding the White House’s supposed “fix.” For starters, the administration’s plan is completely lawless, as many others have noted. The president has not altered any regulations or asked Congress to provide a carve-out for the 2013 insurance plans. He instead announced he would not enforce the law for a year, which the administration claims should be enough for state regulators and the insurance industry to reopen the canceled plans.

Of course, this is not the way to run the government. In the near term, it’s not at all clear that states and insurers aren’t still exposed legally. What if an insurance enrollee sues an insurer for not providing an Obamacare-required benefit? Would that have standing in court? Who knows?

You can read the rest of the column here.





 


posted by James C. Capretta | 11:33 am
Tags: individual market, individual mandate, exchanges, Fred Upton
File As: Health Care

Obamacare's Mugged by Reality Moment

With the serious setbacks facing the implementation of the Affordable Care Act, it is starting to look like it would be best for opponents of the law to wait for the disaster to unfold to reap the political benefits of its collapse in 2014.

But, as I argue in a column at The Weekly Standard, pushing for delaying the individual mandate should remain a key part of the GOP's opposition to the law in the months ahead.

There are many conservatives who fully expect the law to collapse under its own immense weight, and who anticipate that they will reap the political benefits of that collapse in 2014 no matter what they do now. So why engage in another politically risky showdown with the president?

Certainly the GOP shouldn’t repeat the mistaken tactics of the last month. But there’s every reason to continue making a delay of the individual mandate the GOP’s top priority in the negotiations with the Obama administration and Senate Democrats over the coming months.

For one thing, there will never be a better time to press the case for a mandate delay. The rollout of Obamacare is a complete mess. The voters can see for themselves that enrollment in Obamacare is a completely unreasonable proposition at this stage, even with the administration’s recent announcement that it will treat any enrollment commitments made before April 1 as satisfying the coverage requirement (previously, the cut-off to avoid the uninsured tax was thought to be mid-February, because the law allows for three months without coverage in a calendar year and it can take several weeks to go from an enrollment submission to initiation of insurance coverage). It should be obvious that the system for determining subsidy amounts for households has not been tested nearly enough to ensure it is reliable and will not waste billions in taxpayer dollars. It will be impossible for the administration to continue its defense of the individual mandate if these conditions remain substantially unchanged through the end of 2013.

You can read the rest of the column here.

posted by James C. Capretta | 2:13 pm
Tags: Obamacare implementation, individual mandate
File As: Health Care

Win the Argument

How the GOP Can Get the Upper Hand

In a column at The Weekly Standard, I argue that Republicans should use the budget debates over the government shutdown as a chance to argue for a delay of the Affordable Care Act's individual mandate.

The political and substantive case for a delay in the individual mandate is compelling.  On a political level, what politician wants to defend giving a one-year break to corporate America but not to the little guy?  That’s exactly the position Democrats are now in, and the GOP can swing public opinion their way by making this the central theme of their public case.  In the coming days and weeks, there will be no shortage of opportunities for GOP members and Senators to go on TV, and they should use every chance they get to pound the message home with voters that the Democrats are the ones protecting businesses but not workers.

Substantively, the case is just as strong.  The administration has delayed enforcement of the employer mandate for a year, which means some workers will not get an offer of coverage at their place of work.  Because the individual mandate is still in place, they will have to go into the exchanges to get insurance or pay the uninsured tax.  In two states, New Hampshire and West Virginia, there’s only one plan being offered in the exchanges.  In other states, there are very few choices.  Is it really fair to force American to buy insurance from one insurance carrier, or limit their choices to even two or three plans?  The administration says it will start enforcing the employer mandate in 2015, which means many workers who were forced into the exchanges in 2014 will be forced out of them in 2015 when they get offered employer plans.  Does disrupting insurance like this make any sense?  The GOP should make these points to show that a delay of the employer mandate necessitates a commensurate delay of the individual requirement.

You can read the rest of the article here.

posted by James C. Capretta | 10:53 am
Tags: Obamacare, individual mandate, delay
File As: Health Care

The Soft Underbelly of Obama­care

One of the challenges facing opponents of Obamacare has been that there is so much wrong with the law, it can be difficult to choose a single target to focus on. But as Yuval Levin and I explain in an article in The Weekly Standard, the individual mandate, one of law’s most important provisions is also one of its most problematic and unpopular.

The law’s champions have always considered the individual mandate to be the indispensable provision. It is what allows them to make the only boast they really care to make, which is that the law—in their estimation—will deliver on the long-sought goal of “universal coverage” (which now appears to mean covering all but 30 million people in our country). And it is what allows them to attempt to transform the purchase of government-sanctioned health insurance from just another consumer choice into a social obligation, if not a legal decree.

Of course, the mandate has already ceased to be the obligation that Obamacare’s architects wanted it to be. In his landmark ruling in NFIB v. Sebelius last summer, Chief Justice John Roberts found that Congress did not have the authority under the commerce clause to make the purchase of health insurance obligatory. The only way the “personal responsibility” requirement was found constitutional was as a tax on the uninsured: Citizens can either purchase insurance or pay that tax. Both options are perfectly permissible under the law. Indeed, the Roberts decision suggests that Congress could never raise the tax very much because that would tip the balance away from providing a genuine choice to imposing a de facto obligation to buy coverage.

The rest of the piece can be read online here.

posted by James C. Capretta | 10:23 am
Tags: Obamacare, individual mandate, Yuval Levin
File As: Health Care

Obamacare as “Play or Pay”

I have a new post up at National Review Online on how today's Supreme Court decision raises some interesting questions about how Obamacare will operate in the real world:

The Congressional Budget Office (CBO) and others have suggested that the presumed mandatory obligation to buy health insurance would be a very powerful motivator for those who today choose to remain uninsured to purchase coverage, even though the “penalty” they must pay is generally far less than the premiums for even bare-bones health insurance. In other words, the CBO assumes these people will go along with the program because everyone else is going along with it and, well, it’s the “right thing to do.”

This was always a dubious assumption, as it presumes people will act against their own self interests. But it would seem even less plausible now because the Supreme Court, in its language today, has made it clear that the mandate cannot be viewed as a mandate at all; it’s just an optional tax that citizens can pay in lieu of securing health insurance.

You can read the rest of the article here.

posted by James C. Capretta | 7:28 pm
Tags: individual mandate
File As: Health Care

All the President’s Mandate Positions

I have a new column up at National Review Online on Obama’s history of flip-flops on the individual mandate:

Without the mandate, the Obama plan would not be considered a “universal coverage” plan in Democratic circles, as analysts, including those at the Congressional Budget Office, would expect large numbers of Americans to decline to sign up for coverage in a voluntary system. Party elites and activists would regard this as a major, perhaps even fatal, flaw. Nothing in the Democratic catechism is more sacred than the goal of “universal coverage” in health care.

So Senator Obama was taking a risk in not toeing the party line. But it was a calculated risk. He knew from polling data that, despite its popularity among party elites and left-leaning health-care analysts, the individual mandate was far less popular among Democratic primary voters. Here was a policy difference with Senator Clinton that he could exploit to his advantage in the primaries.

You can read the rest of the article here.

posted by James C. Capretta | 3:00 pm
Tags: individual mandate
File As: Health Care

What Now for the Supreme Court?

Over at National Review Online, I’m one of several respondents to a symposium asking the question, “Now that the oral arguments are over: What should SCOTUS do?” Here’s the beginning of my short response:

Yes, Obamacare is “unprecedented” — an unprecedented federal power grab. If allowed to stand, the law would steadily shift immense control over the entire health sector from states, employers, private companies, and individuals to federal bureaucrats. And once the big changes scheduled for implementation in 2014 are set in motion, they will be very difficult to reverse later.

The rest of the response is here.

posted by James C. Capretta | 3:26 pm
Tags: individual mandate, Supreme Court
File As: Health Care

It’s Not Just About the Individual Mandate

I have a new Weekly Standard article on the need not to focus exclusively on the individual mandate in undoing Obamacare:

Obamacare’s individual mandate — requiring that all Americans purchase government-approved health insurance beginning in 2014 — has always been the law’s most vulnerable provision. It is incredibly unpopular, and not just among conservatives. Polls consistently show that a large majority of the electorate opposes it, including a good portion of registered Democrats....

[However], even if the Supreme Court were to strike down the mandate, much of the rest of the law would almost certainly remain in effect. That’s unacceptable. Obamacare without the mandate is nearly as bad as Obamacare with it.

In the end, the fate of Obamacare will almost certainly be decided in the political and legislative arena, not the courts, and the 2012 election is likely to be the decisive battle in that regard. Keeping this in mind, Republicans and conservatives should be doing all they can to make the 2012 election another referendum on the damage Obamacare will do to the American economy and health system....

You can read the whole article here.

posted by James C. Capretta | 2:04 pm
Tags: repeal, individual mandate, Supreme Court
File As: Health Care

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