In a January 2008 Democratic presidential debate, then-Sens. Hillary Clinton and Barack Obama both promised to deliver universal health care plans. But Obama hit Clinton for supporting a requirement that individuals buy their own health care.
"She believes that we have to force people who don't have health insurance to buy it. Otherwise, there will be a lot of people who don't get it," Obama charged. "I don't see those folks."
After winning office, however, Obama came around to Clinton's point of view. No surprise. As the fiscal watchdog group the Concord Coalition noted in a policy brief, the individual mandate, by guaranteeing a healthier insurance pool is what allows the new system to avoid this "death spiral" of increasing insurance costs.
So it is ironic -- deserving? -- that the very mandate against which candidate Obama campaigned could prove to be his plan's weakest link.
Now, I am not rooting for conservatives to win in federal court on the grounds that it is unconstitutional to require Americans to buy something. How is it constitutional for Washington to make me pay for someone else's health care but unconstitutional to make them pay for their own care? Nor do I relish the prospect of federal judges overturning a law enacted by elected officials.
That's why House Republicans were right to vote to repeal Obamacare on Wednesday. This is how politics should work.
Consider how the previous Congress jammed through the Patient Protection and Affordable Care Act with too little scrutiny and barely any debate over costly provisions.
The Democrats' health care plan also included a new Community Living Assistance Services and Support Act -- which set up a federal voluntary long-term care insurance fund. As the Concord Coalition noted, by promising to pay in-home care benefits for which countless seniors could qualify, the program invites "induced demand." What's more, Medicare and Medicaid chief actuary Richard S. Foster warned that adverse selection -- those who sign up are the most likely to present claims -- is likely to make the program "unsustainable."
Obamacare's requirement that health plans include adult children -- up to age 26 -- as ordinary dependents of insured workers has added to the price of employer-paid plans. That provision helped prompt SEIU 1199, the large and powerful local health care workers union on the East Coast, to drop dependents' health care coverage from its plan.
Ditto the requirement that plans not charge co-payments for services deemed to be preventive. The bill was classic Washington: politicians lavishing unfunded benefits -- while demanding that others exert restraint.
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