On Individual Mandates and Flip-Flops
EmailYou can be forgiven if, during this debate on whether the federal government should have the right to require citizens to obtain health insurance – the so-called “individual mandate” – you get whiplash.
Both Democrats who now support the mandate once opposed it…and Republicans who are calling it unconstitutional once proposed it.
During the Democratic presidential primaries, the mandate – not a major point of contention in President Obama’s health care reform law – was a debate point between then-Sen. Barack Obama, D-Ill., and then-Sen. Hillary Clinton, D-NY.
Clinton's health care proposal required Americans to have health insurance. Obama's didn't.
"Senator Clinton is arguing that the only way to get every American covered is if you force every American to buy health care," Mr. Obama told Iowa reporters in November 2007. "And unfortunately she hasn't told anybody how she would enforce this mandate."
During a contentious debate in Las Vegas, Nevada, Mr. Obama said "the only difference between Senator Clinton's health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated — forced — them to get health care. That's not what I'm seeing around Nevada. What I see are people who would love to have health care. They — they desperately want it. But the problem is they can't afford it."
He underlined again during the debate: "I don't think that the problem with the American people is that they are not being forced to get health care."
Last June, President Obama told ABC News’ Diane Sawyer that he’d come around to Clinton’s way of thinking.
President Obama said that while "mandates are an example of… something that I was resistant to during the campaign… this is an area where people have made some pretty compelling arguments to me that if we want to have a system that drives down costs for everybody, then we've got to have healthier people not opt out of the system. And I think that you have to be careful to make sure that there's a waiver. So that if we haven't made health care affordable yet, you're not punishing people, not only because they can't afford health care, but — now giving 'em an additional fine."
The president said that "any program that we put in place, I think there will be some phase-in period. So that we can calibrate and adjust to make sure that there really is affordability there before we start trying to penalize people. But I think my thinking on the issue of mandates has evolved. And I think that that is typical of most people who study this problem deeper."
Interestingly, even as Republican state attorneys general from across the country prepare legal action against the Obama administration for the individual mandate, which they claim is unconstitutional, the concept was actually a Republican idea.
Conservative economist Mark Pauly told NPR that back in the 1980s, when Democrats were talking about an employer mandate, "a group of economists and health policy people, market-oriented, sat down and said, 'Let's see if we can come up with a health reform proposal that would preserve a role for markets but would also achieve universal coverage.' "
There was no other way to do it, Pauly said, because otherwise "there would always be some Evel Knievels of health insurance, who would decline coverage even if the subsidies were very generous, and even if they could afford it, quote unquote, so if you really wanted to close the gap, that's the step you'd have to take…There was a kind of an ethical and moral support for the notion that people shouldn't be allowed to free-ride on the charity of fellow citizens."
This is essentially the argument made on CNN’s Larry King last night by former Massachusetts Gov. Mitt Romney, who said about the Massachusetts health care reform plan he helped form – which includes an individual mandate – that “right now in this country, people that don't have health insurance go to the hospital if they get a serious illness, and they get treated for free by government. By plan says no, they can't do that. No more free riders. People have to take personal responsibility. I consider it a conservative plan.”
In 2006 Romney wrote a Wall Street Journal op-ed that made a similar argument, but significantly many of those who are arguing against the constitutionality of the president’s bill say states have the right to impose an individual mandate, but the federal government does not.
When asked about the lawsuits Tuesday, White House press secretary Robert Gibbs said, “I think Utah is one of the states that's thinking about doing this. Senator Hatch and Senator Bennett have both been on legislation requiring some level of individual responsibility like this.”
Gibbs was referencing a bill that in 1993, the late Sen. John Chafee, R-RI, introduced: the “Health Equity and Access Reform Today Act of 1993," which included the individual mandate.
The Kaiser summary of that bill states that the bill included “Subtitle F: Universal Coverage – Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005. Provides an exception for any individual who is opposed for religious reasons to health plan coverage, including those who rely on healing using spiritual means through prayer alone.”
Co-sponsors of the legislation included Sen. Orrin Hatch of Utah, Sen. Bob Bennett of Utah, Sen. Christopher “Kit” Bond of Missouri, Sen. Chuck Grassley of Iowa, Sen. Bob Dole of Kansas, and 12 other Republicans and two Democrats.
Hatch today tweeted “This article explains why the individual mandate is unconstitutional,” providing a link to this story in which he himself is quoted saying that if the individual mandate is “held constitutional — for them to be able to tell us we have to purchase health insurance — then there is literally nothing that the federal government can't force us to do. Nothing."
Hatch spokeswoman Antonia Ferrier today said that her boss supported the 1993 legislation “as an alternative to HillaryCare,” the health care reform bill offered by President Bill Clinton and then-First Lady Hillary Clinton.
“Senator Hatch supported this alternative to President Clinton’s massive federal takeover of the American health care system, because his number one priority was the defeat of yet another big government assault on health care that the people of Utah overwhelmingly opposed,” Ferrier said in a statement. “In the intervening years, he went back and carefully examined, in close consultation with constitutional experts, the legal problems with many of the bills being supported at the time. This needed to be done, because of the hasty nature of the debate at the time. It is simply a fact that Congress has never imposed this kind of mandate before. Senator Hatch concluded, as would any intelligent scholar of the Constitution, that this federal mandate requiring Americans to either purchase health insurance or face a punitive tax exceeds the authority the Constitution has given to Congress.”
– jpt
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I don’t see anything wrong with changing your opinion if you have access to new information that makes the better answer obvious. Obama, in this case, did get new info that made it clear, that mandating insurance for everyone was necessary to lower costs.
Posted by: Lydia | March 24, 2010, 6:45 pm 6:45 pm
Great post. Have been thinking a lot about this since I watched all the debates and remembered he made it such a huge bone of contention with Hillary.
The way Obama ran his primary and the way he’s running his administration are very different, which is fine. I don’t really have a problem with people changing their positions, but it’s important for people to acknowledge.
Also, I hope one day people will stop bashing Hillary and give her the credit she deserves for having the right answers on health care (and many other things) all along.
Posted by: C | March 24, 2010, 6:51 pm 6:51 pm
Pointing out that Obama is a liar is long past being news as it’s second nature to the man.
Posted by: bobmac | March 24, 2010, 6:57 pm 6:57 pm
When the government mandates the citizens spend their money to buy a product, where does it stop? How much of your freedom has to be taken away before your realize that you are a slave?
Posted by: tisha | March 24, 2010, 6:57 pm 6:57 pm
bobmac, no one called Obama a liar. Isn’t changing your opinion the mature thing to do? Obama, as the article states, heard from lots of health care experts who said mandatory insurance was the only way to truly lower premiums. So he changed his opinion. That isn’t lying.
Posted by: Lydia | March 24, 2010, 7:29 pm 7:29 pm
tisha, having health care insurance is as much a necessity as having auto insurance if you drive. Otherwise when you get sick or in an accident you risk financial ruin and/or being a burden on everyone else to cover your bills. Buying insurance is being a responsible adult.
Posted by: Lydia | March 24, 2010, 7:31 pm 7:31 pm
The individual mandate wouldn’t be so onerous if there were a government run option. I would prefer that the government not force me to line some rich CEO’s pockets, but I wouldn’t mind a shared committment through a public plan. Better yet, eliminate private insurance entirely, since we formed our government as our insurance policy in the first place.
Posted by: Flash Override | March 24, 2010, 7:38 pm 7:38 pm
Republican hypocrisy about individual mandates is simply stunning.
This healthcare reform plan is centrist, incorporating the mandate idea which has long been supported by Republicans including Romney, Grassley, Dole, and even Gingrich.
By the way, I’ve read that during George Washington’s first term, the Militia Act of 1792 was passed requiring Americans to buy guns and ammo. Apparently many of the Congressmen who voted for this act helped write the Constitution!
Posted by: Danny | March 24, 2010, 7:41 pm 7:41 pm
Rep. Dingell (berry) said “ObamaCare will eventually control the people”.
This must be comforting to the left knowing that soon Obama will be making all of their life decisions for them.
Making their lives simpler, free and easy. Heck Michelle can even tell you what to eat!
Posted by: mick | March 24, 2010, 7:57 pm 7:57 pm
Rep. Dingell (berry) said “ObamaCare will eventually control the people”.
This must be comforting to the left knowing that soon Obama will be making all of their life decisions for them.
____________________________________
Hogwash.
The Republican right seems to fear education and information since it might threaten their freedom to be stupid.
Posted by: tierra | March 24, 2010, 8:01 pm 8:01 pm
Clearly it is unconstitutional for Congress to mandate Americans do purchase something – that much is clear. The reason is that it isn’t being tied to Congress’ power to tax for the general welfare of the country.
Know what the solution is?
How about require a 2.5% tax on every American, that will be used to cover all the new entitlements and subsidies – but allow for a deduction on their tax return if they can prove they have acquired their own insurance?
That would keep the “mandate” within the realm of taxation, it would be mandating a federal income tax instead of the purchase of a service.
Only problem: Barack Obama’s biggest promise during the presidential campaign was that no one with an income under $200,000 would see any new taxes.
Obama could have made this work, within the Constitution, if he had not made the tax promise which everyone understands will expire whenever Obama’s back is up against the wall.
Posted by: George | March 24, 2010, 8:03 pm 8:03 pm
I download the bill, or what was purported to be the bill, but I also see that they are still voting in changes, amendments, and “fixes” (as in “the fix is in”.) So I’m not sure what SoetoroCar law really entails.
Is there an opt-out for conscience/religious reasons: for the Amish, Mennonites, etc? Would this apply to Moslems (as some Moslem say things like insurance is a form of gambling also)? What about other people or non-religious who don’t want to buy SoetoroCare or give money to private, for-profit corporations?
Posted by: Ed | March 24, 2010, 8:22 pm 8:22 pm
Repeal and Replace
Thanks GOP for listening to the people!
Posted by: millie | March 24, 2010, 8:22 pm 8:22 pm
By the way, I’ve read that during George Washington’s first term, the Militia Act of 1792 was passed requiring Americans to buy guns and ammo.
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This was actually as part of these two Acts in 1792 to DRAFT militia into a national force to defend the country (ie a military draft).
BTW it didn’t say ALL AMERICANS it was only those the draft applied to (men ages 18-45) and it said they had to provide their own guns ammo. It, of course, didn’t list a gov’t approved list of ammo, guns, etc. Also important note that in those days most people actually had guns and ammo because instead of supermarkets they used guns to catch food.
Posted by: obieone40 | March 24, 2010, 8:37 pm 8:37 pm
Dingell did indeed say,”it takes time to control the people” and Alcee Hastings said,”rules,what rules,we make them up as we go.” These guys have no problem with lying just as Fidel Obama doesn’t have any problem with lying.He’s very good at it as he’s been practicing his whole life.The Manchurian Candidate incarnate.
Posted by: bobmac | March 24, 2010, 8:38 pm 8:38 pm
“Isn’t changing your opinion the mature thing to do?”
Posted by: Lydia | Mar 24, 2010 7:29:41 PM
Posted by: James Danley | March 24, 2010, 8:39 pm 8:39 pm
The Amish and Mennonites are self insured and are exempt for this health care bill. If you have the means to take of yourself, why should the government mandate that you purchase something you don’t need?
Posted by: rebecca2656 | March 24, 2010, 9:01 pm 9:01 pm
If the republicans fear education so much, why did the republican allow the children in DC failing schools get vouchers and the dems stopped it?
Posted by: rebecca2656 | March 24, 2010, 9:05 pm 9:05 pm
tierra wrote: “The Republican right seems to fear education and information since it might threaten their freedom to be stupid.”
.
A little bit of business knowledge would actually help your side. You might have a slight clue about unintended consequences. But when all you have is a rigid PROGRESSIVE ideology to guide you, then we get the monstrous FRAUD of a “health care reform” bill, since no one in this administration has any actual business knowledge. Then the fact that nationalization of STUDENT LOANS was bundled up in this bill just gives it all away.
Posted by: gk | March 24, 2010, 9:17 pm 9:17 pm
But when all you have is a rigid PROGRESSIVE ideology to guide you,
Man don’t knock until you have tried it. We have millions of unemployed but no worries as this unemployment has been extended time and time again and if you make more by drawing why look for a job. And then theres the food, food stamps galore-take a look around next time you shop and notice all the behinds 2 axe handles wide…they didn’t get that way from lack of food and hard work. And then theres the kids, you mess up and get one in the oven the Govment will take care of all the bills and you’ll be off with another woman with no feelings of guilt from not supporting your kids.
This progressive stuff has only one draw back and that is you still can’t buy beer with food stamps but hey you can sell them and get 50 cents on the dollar.
Yes ,life is good!
Posted by: david | March 24, 2010, 9:31 pm 9:31 pm
Hogwash.
The Republican right seems to fear education and information since it might threaten their freedom to be stupid.
Posted by: tierra | Mar 24, 2010 8:01:29 PM
Abraham Lincoln was stupid?
Posted by: For the Record | March 24, 2010, 9:42 pm 9:42 pm
having health care insurance is as much a necessity as having auto insurance if you drive.
Posted by: Lydia | Mar 24, 2010 7:31:29 PM
It’s not really an apples to apples comparison.
Isn’t auto insurance mandated by each State?
You can actually drive without auto insurance but if you get caught, then the trouble starts.
Besides, as progressives, shouldn’t we be moving forward? Why are we still debating this? Let’s all support the President and buy our health care insurance as soon as possible!
Posted by: For the Record | March 24, 2010, 9:51 pm 9:51 pm
So can I self-insure myself, like the Amish exemption? If I prove enough money on hand? Or do we HAVE to give money to the private, for-profit insurance corporations?
And what about religious faiths, like Islam, that consider insurance a sin or not something to do (I believe there are some fatwas stating this)? I’m sure that is vexing for Obama. Would they need to prove “means” to be exempted or would Moslems need to purchase private insurance per SoetoroCare legislation?
Posted by: Ed | March 24, 2010, 10:01 pm 10:01 pm
So can I self-insure myself, like the Amish exemption? If I prove enough money on hand? Or do we HAVE to give money to the private, for-profit insurance corporations?
Posted by: Ed | Mar 24, 2010 10:01:15 PM
I think that Rush Limbaugh can get a waiver. He has more money than some of the small, poor countries.
Also, do you think Progressive Insurance will start selling health care coverage? With that name, it would be a win-win for us progressives!
And that girl on the commercial is really nice. I bet she’s a progressive – not a right wing hate mongerer.
Posted by: For the Record | March 24, 2010, 10:09 pm 10:09 pm
What’s so brilliant about Obama?
He’s passed two trillion dollar bills and didn’t know what was in either one of them.
Posted by: kyle | March 24, 2010, 10:14 pm 10:14 pm
“I think that Rush Limbaugh can get a waiver. He has more money than some of the small, poor countries.”
Isn’t Rush packing for his move to Costa Rica?
Posted by: Paige | March 24, 2010, 10:14 pm 10:14 pm
“I think that Rush Limbaugh can get a waiver. He has more money than some of the small, poor countries.”
Isn’t Rush packing for his move to Costa Rica?
Posted by: Paige | Mar 24, 2010 10:14:34 PM
Gosh. I don’t know. He could be. Maybe that’s why he moved from NYC to Florida. Kind of a climate transition thing.
I do know that when he got sick in Hawaii he paid cash for all his health care and got a HUGE discount for doing so. Money talks!
Posted by: For the Record | March 24, 2010, 10:31 pm 10:31 pm
What’s so brilliant about Obama?
Posted by: kyle
he’s president…. you……..are not
Posted by: PO'd | March 25, 2010, 12:04 am 12:04 am
And what about religious faiths, like Islam,
Posted by: Ed
And what about religious faiths, like christian scientists who will let their children die rather than take them for treatment…..
or ‘snake handlers’…
Posted by: PO'd | March 25, 2010, 12:07 am 12:07 am
“Gosh. I don’t know. He could be. Maybe that’s why he moved from NYC to Florida. Kind of a climate transition thing.”
Posted by: For the Record | Mar 24, 2010 10:31:42 PM
NOT EXACTLY:
“I’ll just tell you this, if this passes and it’s five years from now and all that stuff gets implemented — I am leaving the country. I’ll go to Costa Rica.”
Rush Limbaugh on his radio show
There’s a WEB site raising money for his one way ticket.
Posted by: Paige | March 25, 2010, 12:20 am 12:20 am
“I’ll just tell you this, if this passes and it’s five years from now and all that stuff gets implemented — I am leaving the country. I’ll go to Costa Rica.”
Posted by: Paige | Mar 25, 2010 12:20:15 AM
Maybe he’ll break his promise. It happens all the time. Sometimes even Presidents break their promises. The important thing is that we keep moving forward. We’ve made a lot of progress so far. We can’t stop now! Live in the moment like Clinton! Now he had some progressive moves!
Posted by: For the Record | March 25, 2010, 12:35 am 12:35 am
“I’ll just tell you this, if this passes and it’s five years from now and all that stuff gets implemented — I am leaving the country. I’ll go to Costa Rica.”
___________________________________
Hysterical nonsense from the Republican right . ..
Posted by: tierra | March 25, 2010, 1:02 am 1:02 am
“I’ll just tell you this, if this passes and it’s five years from now and all that stuff gets implemented — I am leaving the country. I’ll go to Costa Rica.”
___________________________________
Hysterical nonsense from the Republican right . ..
_______________________________
Posted by: tierra | Mar 25, 2010 1:02:01 AM
Don’t be so quick to criticize tierra.
I bet a bunch of ” the Republican right” may be planning a move to Costa Rica.
You can get great Health Care there. In fact you can get great Health Care there and not be a citizen. It’s something called medical tourism and with the passage of YesWeCanCare I bet it becomes very popular among people who have money.
Private Insurance now offers Health Insurance in Costa Rica.
Read below.
Note: Before the 2008 ratification of CAFTA (the Central American Free Trade Agreement), Costa Rica operated under a government-owned monopoly insurance system. In 2009, international insurance providers
began to offer health insurance within Costa Rica.
Costa Rica’s private hospitals and clinics offer high-quality medical care at a tiny fraction of its U.S. equivalent cost. In fact, due to Costa Rica’s beautiful surroundings, medical reputation and very lost costs, the country is rapidly becoming a prime destination for medical tourism.
This may be a way to get around that cadillac insurance tax.
: o )
Posted by: Noz | March 25, 2010, 1:33 am 1:33 am
I bet a bunch of ” the Republican right” may be planning a move to Costa Rica.
You can get great Health Care there. In fact you can get great Health Care there and not be a citizen.
Posted by: Noz | Mar 25, 2010 1:33:01 AM
Lots of people do leave the United States to get health care somewhere else, as much as the Republican right posters on here tried to pretend otherwise while debating health care . . ..
Posted by: tierra | March 25, 2010, 2:30 am 2:30 am
“Lots of people do leave the United States to get health care somewhere else, as much as the Republican right posters on here tried to pretend otherwise while debating health care . . .. ” – tierra
I hear ya tierra.
It’s now possible to get some really good care in a place like Costa Rica for a very reasonable price. One of the reasons for that is there aren’t any outrageous law suits allowed there. Too bad Tort Reform wasn’t a Democrat idea. Since the Repubs are proposing it we, the American People are going to lose out.
(sigh)
Also, this is now possible because the government in Costa Rica is allowing private insurers to offer policies in a move away from their previous monopoly government controlled health care.
Maybe there’s something in the water there that makes their politicians smarter than ours.
Posted by: Noz | March 25, 2010, 7:41 am 7:41 am
HuffPo points out this little Inconvenient Truth about O-Care:
“Myth: This is a universal health care bill.
Fact: The bill is neither universal health care nor universal health insurance. According to the Congressional Budget Office:
Total uninsured in 2019 with no bill: 54 million
TOTAL UNINSURED IN 2019 with Senate bill: 24 million”
So just why did we tear the nation apart to pass this trillion dollar abomination?? Of yeah….Rep. Conyers, Chair of the House Judiciary Committee, reminded us yesterday: “To control the people.”
Posted by: People's Kommissariat of Health | March 25, 2010, 8:39 am 8:39 am
I hear a lot of Spanish speaking people at my concierge medial clinic/hospital.. Costa Rica must not have everything.. or these South Americans would go there.. these are not migrants.. this is a pay go deal.
Posted by: DontGet818OnMeNow | March 25, 2010, 8:52 am 8:52 am
medial – medical
Posted by: DontGet818OnMeNow | March 25, 2010, 8:53 am 8:53 am
The U.S. healthcare system is just overly technical, overused and over priced.. it’s a good way to get well.. if you can take advantage of it.. but it’s a multi tier system of treatment that is allotted by ability to pay and getting another entity to pay
Posted by: DontGet818OnMeNow | March 25, 2010, 9:24 am 9:24 am
Posted by: People’s Kommissariat of Health | Mar 25, 2010 8:39:48 AM
Does Jane Hamsher point out how many people would be covered under the status quo or Republican plans?
No?
I didn’t think so.
But you are correct that our work isn’t done. We must continue to vote in progressives– and support Alan Grayson’s amendment.
Posted by: progressive mama | March 25, 2010, 9:50 am 9:50 am