Should we support the individual mandate?

Medicare for All


Today we're going to be talking about the individual mandate, which is a very wonky policy term for the the requirement that you buy health care, which was included in the Affordable Care Act Now to me like the individual mandate is one of the most bizarre and like fascinating Windows onto American politics, which one that will explain like the strangeness and bizarreness of it. But it's also like timely because of two big things like there's basically two major events happening in politics right now, right? There's Supreme Court nomination the Supreme Court could potentially be tipped way to the right and then we have this you may have heard. We have an election coming up like news news alert. There's an election coming up and the many ties into both of these things. Cuz a lot of people are wondering will this new conservative Court overturn the Affordable Care Act and it turns out the individual mandate is like at the center of that legal wage. And then there's also the issue of what happens if Democrats retake Congress and the presidency, what are they going to do? Because essentially the Mandate was eliminated off or they pulled the teeth out of it a couple of years ago when they're still Republican Congress and you know are Democrats going to reinstate it. What's going to happen either a good or a bad thing. Let's get into it. That's what I introduce Our Guest sure. So we're welcoming to the podcast today. You can camp our old friend Egan who is the health care policy Advocate at public citizen. Happy Halloween again. Hey, thanks so much for having you guys. Can we get you a better like sexier tighter than helpful? Yeah, maybe Health Care policy Champion something like an upgrade. We're going to work on that. Yeah, exactly. So my first question on this episode about the individual mandate is what the hell is a name. No, mandate and specifically how is it different from a text? Yeah. So an individual mandate at its most basic is the idea that you have to have health insurance. And if you don't have health insurance, there's some sort of penalty and so it's it's different from attacks in that. It's it's what you would end up paying if you didn't actually get health insurance. So if you have a health insurance, you know your page whatever your health insurance is, but if you don't have any health insurance, then it's whatever the taxes which is generally going to be less than the cost of your health insurance. But it means you're also not getting anything and you don't actually have health insurance coverage off. Yeah Best of Both Worlds really is being uninsured and then being fine on top of it. So a lot of people who have been, you know, following this at all, the Affordable Care Act may know that at this moment back in general the Republican party is opposed to the individual mandate considers it this tax this requirement to buy insurance is like an infringement on our personal Liberties and in general the Democratic party has wage. In favor of it saying it's you know, what makes the Affordable Care Act work. It's personal responsibility out of data, but it was not always so is the can you give us a little wage of like where did this idea come from? How long has it been kicking around for? Yeah. So an individual mandate is is sort of a conservative way of getting people health care. I mean as you know, we're on the way better care for all health care. Now, that's a much more sort of progressive guarantees access to health care for folks. Whereas just an individual mandate really the idea. There is that you want people to have health insurance and insurers are scared that if folks wait until they're sick and then just buy coverage. That means that they're only going to get the insurers are only going to make money while people are sick, which means they're actually going to have to pay out more and so they want them to be paying all those premiums ahead of time so that they're making their their their profits as they go we would hate for insurers not to make enough profit off. Yeah. Yeah, I mean that's it's something that appeals has appealed to Republicans and Democrats over the years and the health insurance industry gives pretty pretty heavy handily to them both. And so it's not it's not surprising that both parties at different times would would be in favor of it. Yeah, so we're from Massachusetts Ground Zero for ObamaCare actually, as you may know the first real life iteration of Obamacare was of course the Massachusetts Health reform, which was passed on a sort of a bipartisan basis under a republican Governor Mitt Romney who pioneered the idea under what is sort of a Democratic Leadership. If you're familiar with Massachusetts state politics, you know that it's just Democrat has used lightly hear President Bush, of course also expressed really strong support for the idea of a mandate a coupled with the marketplace. So if you think about the ACA as being the three legs two of those legs and Marketplace for health care, and then the idea of the Mandate are like major conservative ideas right there and then you know Obama, you know running for the Democratic primary to be John Edwards and Hillary Clinton. He probably thought he needed to be at least a little bit to the left of the Republican Governor, you know, Romney's Health Care policy although both Clinton and Edwards. Endorse the individual mandate in the primary. So they're apparently cool with running on the Republican policy. I guess the question is how did the Democratic solution you know, we have two of the three major candidates in the 2008 primary running on a republican Health reform. Like how did that Democratic solution become like a personal responsibility? Yeah. It's a great question and it's one that sort of speaks to some of the challenges that I think we're going to face under a potential Biden Administration the idea that if you ought to have sort of a National Health Care system that medicare-for-all that's much easier for folks to sort of get their heads around but if you have right now our system is sort of based on various fragments. There's your basic Private health care. There's Medicare for seniors. There's Medicaid for low-income folks. And so this it felt it seemed like Democrats were less afraid of sort of tinkering with it. System trying to make some way of expanding coverage. They were more afraid of sort of taking on, you know insurers and hospitals directly. And so they figured the the easiest way out was to sort of take personal responsibility option try to attack on a new private insurance system and hope that it ended up covering people as we saw there were some coverage games but the gaps in the system that made way too many people still falling through

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