Moving beyond Mandates

Two interesting pieces in today’s news on mandates.

First, California Insurance Commissioner Steve Poizner is dropping his ballot effort, which would have punished drivers without car insurance by allowing police to seize the license plates (and possibly impound) these drivers’ vehicles.

Instead, he says, “One of the key problems with why people don’t buy auto insurance is a lot of people who come from low-income families believe they can’t afford it.” So, he’s going to focus on expanding the state’s Low Cost Auto Insurance program.


In spite of California’s mandate to obtain car insurance, approximately 14% of drivers remain uninsured, and rates continue to rise. The comments posted about this story about auto insurance refer to high costs — not whether drivers feel like they’re being put upon for being forced to buy insurance. They just want it to be affordable — just like in health care.

This brings me to the second piece, which is “The Great Risk Shift” author Jacob Hacker’s piece in the LA Times about Obama and Clinton’s bickering over to have — or to not have — mandates in health plans.

In fixating on mandates, they ignore the really key elements of their plan — expanding group insurance through expanding public programs, employer-sponsored coverage, and a public insurance pool, which can negotiate for lower (read: affordable — what Americans want) insurance premiums on the public’s behalf.

Even more problematic, it is takes up energy and diverts attention away from combatting the seriously bad “YOYO” (You’re On You’re Own) ideas, which propose to do the opposite — having everyone pay for their own health coverage in little silos, rather than pooling risk.

Hacker includes an individual mandate in his plan, but makes the calculation that Poizner does: the issue isn’t the mandate (or some other required contribution), it’s what you do to make it affordable. That’s the debate for the general election.

Update: Here is Ezra Klein’s take on Hacker’s piece.

Health Access California promotes quality, affordable health care for all Californians.
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