OBAMA AND THE MANDATE.
Now that the primary is over and they're not defending against attacks from mandate supporters, the Obama campaign looks to be edging closer to actually adopting an individual mandate for purchasing health insurance. Which makes sense. My hunch on their health care plan was always that they looked at the Edwards plan as the leftmost pole, figured Clinton would come out with something in the center, and they'd be right there in the "responsible liberal" sweetspot. When Hillary came out with a plan almost identical to Edwards', they were caught unprepared, and ended up in an argument about universality that they'd never meant to start. But for all of the campaigns' mailers and fliers and debater's points, some sort of mechanism that pulls folks into the pool is important, and congressional Democrats and health policy experts were always going to work to impress that on an Obama administration. The danger is that they might have gotten their back up about it, but Patel's remarks suggest a pretty open posture.
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COMMENTS (11)
You were better off when you tried to blame the forthcoming debacle on Max Baucus, you anti-progressive scumbag.
We all know we're getting an expansion of S-CHIP in the next Congress (if we're lucky), and nothing more.
You'll have the rest of your sleazy professional life to bemoan the effects, Ezra.
Posted by: Petey | June 27, 2008 9:22 AM
"some sort of mechanism that pulls folks into the pool is important,"
It wasn't important to anti-progressive scumbag Ezra Klein during the primary campaign, back when it would've mattered.
Why not start writing about how important it is to cover children, Ezra? General Electric won't object to that kinda bold stance. You might even get back on their teevee.
Posted by: Petey | June 27, 2008 9:26 AM
Trust fund scumbag! Trust fund!
Posted by: ppnqmk | June 27, 2008 9:26 AM
The whole mandate thing in the primary was much ado about nothing. Whether the bill will have a mandate or not depends on whether a mandate can get 60 votes in the Senate not whether the President supports it.
Posted by: redwards95 | June 27, 2008 9:57 AM
Patel's individual mandate remarks were made in response to an insurance industry leader suggesting at the same forum that insurers will oppose Obama's plan as currently structured. Insurers are worried that the Illinois Democrat has not tied an individual mandate to "guaranteed issue," the industry's term for requiring patients to be covered without regard to pre-existing conditions.
So the insurer says, basically, if we want guaranteed issue, we have to give them mandates.
This would seem to confirm what many of us were saying, that mandates represent a concession to the center-right (whether reformers like Romney or the insurers Karen Ignagni represents) rather than a progressive goal in and of itself.
Of course mandates or something like them are necessary. But it doesn't make sense for our side to expend the political capital on something their side seems to want.
There's been quite a few post-primary disappointments with Obama (FISA, centrist advisors), so it's nice to know there's one front where he's not looking too bad.
Posted by: Consumatopia | June 27, 2008 10:35 AM
Two thoughts:
Obama displayed a suspicion of mandates as far back as fall 2006 in an interview w/ Joe Klein (I think the quote was something along the lines of them not being "consumate with the American character" or some such thing), so perhaps it wasn't political calculation but, like the rape-death penalty ruling, a long-held belief
That being said, in that interview and many times thereafter, he's repeatedly said he'd be willing to revisit the mandate idea if mandate-less plan didn't work. So, the new rhetoric doesn't strike me as fundamentally different from previous rhetoric. Mandates, for Obama, are not ideal, but something he's willing to work with if they're necessary to make the system work or, seemingly, necessary to get the bill passed.
That jives with the "he's a pragmatist, not an idealogue" thing we've been talking about for some time now, and especially recently.
Posted by: Michael | June 27, 2008 10:45 AM
Add to that Neera Tanden's hiring as director of domestic policy and it does seem we are really going in that direction
Posted by: benjamin | June 27, 2008 10:51 AM
Found the article. This is basically what he said throughout the primary, and doesn't clash at all w/ what his adviser is saying in Ezra's link:
Posted by: Michael | June 27, 2008 10:58 AM
Petey, you're nuts.
Posted by: Peter K. | June 27, 2008 1:58 PM
With universal catastrophic insurance, everyone would just be "covered" against devastating loss. No need for a "mandate" as such, except that insurance underneath the catastrophic umbrella should be mandatory for children (otherwise, they may be denied early necessary care). The one key rule necessary for the optional health insurance? If you, the insurance company, want to play in this market, no denial of coverage or discriminatory pricing for pre-existing conditions is allowed.
Posted by: urban legend | June 28, 2008 12:59 PM
The Time article on the MA quoted above says:
"The plan requires everyone who earns three times the poverty rate to purchase health insurance and subsidizes those who earn less than that."
That's not true at all. Adults are required to buy coverage if they are offered a plan that meets the affordability standards. In MA, insurance prices vary based on age, constrained to a 2:1 ratio (most expensive no more than two times the cheapest).
Under the affordability schedule, young people just over 300% of poverty do have to buy a plan, but as you get older the income by which you're required to buy a plan goes up, fairly substantially. So 50-year olds aren't required to buy a plan until they make over 500% of poverty.
Posted by: MA Health reform watcher | July 3, 2008 4:57 PM