November 27, 2017

Scrap the ObamaCare Mandate

Alaska senator Lisa Murkowski, a Republican, repeatedly opposed her party’s attempts this year to repeal the Affordable Care Act. But doing away with the ACA’s individual mandate, a change included in tax-reform legislation being readied by Senate Republicans, is a different matter.

Alaska senator Lisa Murkowski, a Republican, repeatedly opposed her party’s attempts this year to repeal the Affordable Care Act. But doing away with the ACA’s individual mandate, a change included in tax-reform legislation being readied by Senate Republicans, is a different matter.

“I have always supported the freedom to choose,” Murkowski wrote in an op-ed for the Daily News-Miner in Fairbanks. “I believe that the federal government should not force anyone to buy something they do not wish to buy, in order to avoid being taxed.”

Murkowski’s positions — unwilling to kill Obamacare but very willing to kill the individual mandate — put her squarely in the mainstream. The individual mandate, unfair and ineffective, has always been the most disliked feature of the law, and not just by Republicans.

From the outset, Americans across the spectrum resented the notion that the federal government could order citizens to buy something they didn’t want — not as a condition to doing something, the way auto insurance is required for those who wish to drive a car on public roads, but simply for being alive. According to an Economist/YouGov survey in February, the requirement to have health insurance or pay a tax penalty was opposed by two-thirds of U.S. adults. In May, a Harris Poll found that 58 percent of the public opposed the individual mandate, with only 24 percent in favor.

You can be a liberal Democrat committed to affordable health insurance for everyone and still be against an individual mandate. That was Barack Obama’s original position, and he reiterated it often during his 2008 campaign. “If a mandate was the solution,” he said in a Super Tuesday interview, “we could try that to solve homelessness by mandating that everybody buy a house. The reason they don’t have a house is they don’t have the money.”

It was a good argument then; it’s an even better argument now. In 2015, IRS Commissioner John Koskinen reported to Congress, about 6.5 million American households paid the tax penalty for not having health insurance. The fine isn’t trivial. Tax filers this year who don’t acquire health insurance must pay the government a fee equal to $695 per adult plus $347.50 per child, or 2.5 percent of total family income — whichever is greater. Yet, steep as the penalty is, millions of Americans would rather fork it over than buy medical insurance they don’t want or can’t afford. Nearly 80 percent of those who paid the fee in 2015 earned less than $50,000.

The individual mandate amounts to a tax on low- and middle-income families. And it would be whacking considerably more than 6.5 million households (the number of uninsured is about 28 million) if not for all the “hardship exemptions” included in the ACA. For example, anyone who is homeless or recently faced eviction or foreclosure is not required to obtain insurance. Neither are taxpayers who experienced domestic abuse, filed for bankruptcy, had a utility shut off, or went to prison.

With Obamacare’s hefty subsidies, Congress has underwritten many people’s purchase of health care plans. But it has also wrecked the individual insurance market, causing premiums to skyrocket and competition to collapse. That may not be a salient issue for the 82 percent of Americans whose insurance comes from their employers or through Medicare and Medicaid. It’s a huge issue for those with no insurance recourse other than the individual market, and who don’t qualify for (or know about) the exemptions from the mandate.

In Murkowski’s words, “There are many for whom this law has not been helpful” — those who make “the calculated risk to go without insurance and pay the tax … They prefer to take a gamble, pay for care out of pocket, and hope nothing too bad happens because the insurance available to purchase is unaffordable.” For several million American families, the mandate penalty is a perverse bargain: Better to pay the IRS a stiff fine that nets them nothing than to pay many thousands of dollars in premiums and deductibles for overpriced insurance.

The argument against repealing the individual mandate is that without a law corralling healthy Americans into the overall insurance pool, insurers will face a death spiral: Only sick people will have an incentive to be insured, so average payouts for those with insurance will rise, so insurers will keep raising premiums, so even more people will forgo insurance, so costs and premiums will rise even more, until insurers abandon the individual market altogether.

But the argument fails on both moral and practical grounds.

As a moral matter, it’s intolerable to treat citizens as mere instruments of an economic policy. Government has no right to force Americans to engage in unwanted commercial transactions just because that’s the only way a Rube Goldberg policy can be made to work. The IRS doesn’t penalize taxpayers for not having children, not buying a car, or not going to college. It is unjust to penalize them for not buying health insurance. From that perspective alone, the individual mandate is an outrage.

Even as a practical matter, however, the individual mandate has been a flop. Not only does it hurt the working poor, it has done little — as even a key Obamacare architect, Jonathan Gruber, has acknowledged — to boost coverage rates. Universal health coverage may or may not be a worthy goal, but penalizing a small fraction of non-affluent taxpayers is an especially lousy way to pursue it.

Obama had it right the first time: Health insurance should be voluntary. Punishing people for not buying something they can’t afford isn’t good public policy. It’s just mean. Congress is divided on the future of Obamacare, but scrapping the individual mandate deserves bipartisan support.

Jeff Jacoby is a columnist for The Boston Globe.

Who We Are

The Patriot Post is a highly acclaimed weekday digest of news analysis, policy and opinion written from the heartland — as opposed to the MSM’s ubiquitous Beltway echo chambers — for grassroots leaders nationwide. More

What We Offer

On the Web

We provide solid conservative perspective on the most important issues, including analysis, opinion columns, headline summaries, memes, cartoons and much more.

Via Email

Choose our full-length Digest or our quick-reading Snapshot for a summary of important news. We also offer Cartoons & Memes on Monday and Alexander’s column on Wednesday.

Our Mission

The Patriot Post is steadfast in our mission to extend the endowment of Liberty to the next generation by advocating for individual rights and responsibilities, supporting the restoration of constitutional limits on government and the judiciary, and promoting free enterprise, national defense and traditional American values. We are a rock-solid conservative touchstone for the expanding ranks of grassroots Americans Patriots from all walks of life. Our mission and operation budgets are not financed by any political or special interest groups, and to protect our editorial integrity, we accept no advertising. We are sustained solely by you. Please support The Patriot Fund today!


The Patriot Post and Patriot Foundation Trust, in keeping with our Military Mission of Service to our uniformed service members and veterans, are proud to support and promote the National Medal of Honor Heritage Center, the Congressional Medal of Honor Society, both the Honoring the Sacrifice and Warrior Freedom Service Dogs aiding wounded veterans, the National Veterans Entrepreneurship Program, the Folds of Honor outreach, and Officer Christian Fellowship, the Air University Foundation, and Naval War College Foundation, and the Naval Aviation Museum Foundation. "Greater love has no one than this, to lay down one's life for his friends." (John 15:13)

★ PUBLIUS ★

“Our cause is noble; it is the cause of mankind!” —George Washington

Please join us in prayer for our nation — that righteous leaders would rise and prevail and we would be united as Americans. Pray also for the protection of our Military Patriots, Veterans, First Responders, and their families. Please lift up your Patriot team and our mission to support and defend our Republic's Founding Principle of Liberty, that the fires of freedom would be ignited in the hearts and minds of our countrymen.

The Patriot Post is protected speech, as enumerated in the First Amendment and enforced by the Second Amendment of the Constitution of the United States of America, in accordance with the endowed and unalienable Rights of All Mankind.

Copyright © 2024 The Patriot Post. All Rights Reserved.

The Patriot Post does not support Internet Explorer. We recommend installing the latest version of Microsoft Edge, Mozilla Firefox, or Google Chrome.