The Spectacle Blog

The Only Thing Worse Than Obamacare is Obamacare Without A Mandate

By on 11.16.11 | 8:56AM

The word on the AP wire is that, if the Supreme Court considers Obamacare's mandate severable and unconstitutional, the Obama Administration will go forward with implementation as planned.

But privately, there's a Plan B: If the court strikes down the law's unpopular linchpin — the so-called individual mandate requiring most Americans to carry health insurance — the administration would take whatever's left and try to put that into in place.

I cannot emphasize the title of this post enough: Obamacare is a step in the wrong direction for the U.S. health care system - but Obamacare without a mandate would absolutely decimate it. There was a lot of conservative consternation about how a death spiral - in which fewer and fewer people bought health insurance and drove the price higher and higher as the insured pool becomes only sick people - would occur in the event Obamacare would be passed in full. This is mainly true because the mandate penalty is currently set too low. But without a mandate penalty at all, this is an inevitable reality: why would anyone buy health insurance if insurers can't discriminate on price and health of the insured? Just wait to get sick, buy it at the same price you'd have bought it at when healthy, and presto: cheap health care.

I know the Obama Administration isn't exactly itching for another health care fight, but if the mandate goes down, the only responsible thing to do is also repeal community rating and guaranteed issue. They can keep the expansion of Medicaid (also up for the constitutionality debate) and the premium supports for low-income Americans as the "centerpieces" of the law. However, if there's no mandate, other Obamacare provisions must be repealed. There is simply no other responsible move here.

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