Individual Mandate

So much for a truce…

Jacob Hacker–soon to be at if UC-Berkeley–may have been someone who helped advise the Democratic candidates on their health care plans, but they didn’t listen to his LA Times op-ed yesterday asking for a truce on the question of an “individual mandate.” They spent 16 minutes of their Ohio debate last night on the differences of their health care plans, mostly on the individual mandate. As Hacker says, it’s not the central benefit of either of their health plans. Rather, it’s the ability to make coverage more available, affordable, and automatic through group coverage. In their debate, they are arguing over details that neither of their plans currently spell out. Obama is right to take umbrage at Clinton’s suggestion that […] Read More

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. BINGO. 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 — […] Read More

Failure to comply with mandate

Many senators are asking about what would happen to those Californians who fail to — or are unable to — comply with the mandate. It’s a good question and it’s a concern that has spun many rumors about some faceless bureaucrat — knocking at your door, garnishing wages, putting liens on your house. Here’s the real scoop: ABx1 1 says nothing about this kind of enforcement. Additionally, such behavior by a state agency (ie. Franchise Tax Board) would not be permitted until a) the Legislature approves legislation on that issue and b) the Legislature approves funding for enforcement, which is unlikely given the existing funding shortfall. What ABx1 1 does say is if a person does not have coverage after […] Read More

Reich on moving beyond mandates…

Robert Reich, former U.S. Secretary of Labor, and now at UC-Berkeley, makes a lot of sense: The individual mandate is the wrong thing to focus on in health reform. Those who are spending lots of time on this particular component, either promoting mandates or opposing mandates, are missing the main debate. Read the whole article. He first makes clear: the three Democratic presidential candidates have very similar, comprehensive plans: Mandates are a sideshow, and fighting over them risks turning away voters from the main event. In almost every important respect, all major Democratic plans are the same. They require employers to “play or pay” — either provide coverage to their employees or contribute to the cost of coverage. They create […] Read More

More on (individual) mandates…

In the national debate about mandates, many are making mountains out of molehills. To recap from earlier posts on this blog: Even though their plans are incredibly similar, Clinton and Edwards are making a big deal that Obama’s plan doesn’t include one element, an individual mandate, even though he has said repeatedly that he would consider including an individual mandate later. Obama says he wants universal coverage and would accept a mandate, but first wants to focus on making coverage available and affordable. Clinton and Edwards say they will make coverage available and affordable (through largely the same mechanisms), and then place a mandate to ensure everyone is in the system. I am in agreement with Robert Laszewski at the […] Read More

The rhetoric of reform…

In the discussion over the individual mandate among the presidental candidates, blogger Ezra Klein, NY Times columnist Paul Krugman, and others with good liberal credentials are making the progressive case for an individual mandate, and even making it a litmus test for a serious health proposal. ARE INDIVIDUAL MANDATES A MUST? The argument goes like this: progressives believe in social insurance, where everybody needs to participate. If there isn’t a requirement that we all need to contribute to health care, you undermine the fabric of social solidarity, the concept of universality. There’s something to that. Other commentators don’t see the “individual mandate” issue as the defining issue, including Matt Ygleisa at The Atlantic, Kevin Drum at the Washington Monthly, Richard […] Read More

Primary fights over secondary issues…

The Los Angeles Times reports on the debate among the Democratic presidential candidates over the so-called individual mandate. It been strange seeing this play out nationally, within the very vague terms of presidential campaign position papers… while we’ve been grappling with the nuts-and-bolts of these same issues here in Sacramento. I’m a little confused about the fuss. The three proposals, by Edwards, Obama, and Clinton, are all very similar. Edwards and Clinton are trying to make a distinction with Obama, in that they have a individual mandate, and Obama doesn’t. But Obama does not say he oppose the individual mandate–he said repeatedly that he would consider it, but his first goal is to make coverage affordable. At the same time, […] Read More

Strange bedfellows

Insurance agent Alan Katz responds on his blog to my recent post about the need for an affordability standard in the context of an individual mandate. In my comments, I did mistakenly lump him in with the Governor and some insurers, who have publicly taken a hard-line “no exemptions” position. Unfortunately, they don’t have blogs I can link to like Mr. Katz does. He concurs that there’s needs to be a “safety valve” for consumers–as well as in other parts of the reform package. We agree. Now only if we can get the Governor there. I hope that this article by the AP’s Laura Kurtzman on the individual mandate and affordability helps. Health Access California promotes quality, affordable health care […] Read More

Crash test…

Today’s LA Times includes a reminder that an individual mandate doesn’t create universal coverage: The Department of Insurance is unsure exactly how many of California’s 23.2million licensed drivers don’t buy insurance. Estimates range from a low of 3.2million to a high of 5.7 million. That’s a 13-25% uninsurance rate. Let’s remember that auto insurance is far smaller amount of money than a health insurance policy. On the other hand, for those who make the analogy, let’s also remember that you don’t need to get auto insurance for your car… you just need to get it for those you crash into. Health Access California promotes quality, affordable health care for all Californians.

Getting educated from the Commonwealth…

So I have a love/hate relationship with Massachusetts. I am a Bronxite who roots for the Yankees, and I’m beside myself that the Red Sox are up 3-0 in the World Series. (Go Rockies!) But I have fond memories goingt to college at Amherst, and loved the formal close of our Commencement, with the banging of a large staff and the pronouncement: “God save the Commonwealth of Massachusetts.” On health policy, I was happy that Massachusetts helped focus attention on state reforms for expanding coverage, although I remind folks that California was one percentage point away a few years earlier, in 2003, with SB2 and Prop 72. On the actual reform plan, it’s not our place to support or oppose […] Read More