Ezra Klein of the Washington Post has said a version of this already today, but it’s worth repeating. There is only a very, very slim chance that the individual mandate will be repealed by Congress, despite Politico’s contention that the policy might be on the ropes thanks to four Democratic senators.
As Ezra points out – and as I have in the past – there are viable alternatives to the individual mandate, the goal of which is to prevent Americans from purchasing health insurance only when they get sick. The alternatives to forcing people to buy insurance are so viable and the mandate so controversial, I’ll bet some Administration officials and congressional Democrats are kicking themselves for not considering them more seriously. But consider them seriously and publicly they did not. The health insurance industry, which is guaranteed a huge new base of consumers by the individual mandate, is part of the reason.
Yet, for the reasons it might seem possible, it’s hard for me to imagine the scenario Politico does, in which a few moderate Democrats lead a successful charge to reform or replace the individual mandate. The reason: politics. Sens. Joe Manchin, Claire McCaskill, Jon Tester and Ben Nelson – all up for re-election in 2012 and identified by Politico as threatening the future of the individual mandate – aren’t going to support repealing it without a replacement that has real teeth. They might be willing to entertain the idea of a strict open enrollment period or even a new tax on every American that’s then waived for those with health insurance. (These are two of the most oft mentioned alternatives that would easily pass constitutional muster.) But these four senators can’t pass such a change alone. They would need Democratic or Republican support and they’re probably not going to get it.
The bulk of Democrats who crafted and passed the individual mandate aren’t anxious to scrap the policy and thereby admit they made a huge political, policy and possibly constitutional error. And so long as Republicans are leading the legal challenge to the individual mandate in federal court – and are wracking up high-profile wins along the way – they’re not likely to cancel out that effort by getting rid of the mandate in the meantime. Plus, Republicans in both houses of Congress just voted to repeal the entire Affordable Care Act, not the kind of move that signals a willingness to surgically improve various aspects of the sweeping new law.
(That said, I think it’s very possible that factions of Republicans and Democrats could join together to change some other less important provisions of the law in the next several years.)