REMEMBER HOW MUCH REPUBLICANS HATE THE INDIVIDUAL MANDATE?…. If there’s one thing GOP officials agree on when it comes to the Affordable Care Act, it’s their disgust for the individual mandate. Never mind the fact that the mandate was their idea, Republicans have labeled this provision of the health care law to be an outrageous, un-American assault on liberty. In some conservative circles, it’s downright tyrannical.
Now, any serious person listening to the hysteria has to realize Republicans don’t actually mean any of this. Indeed, many of those characterizing the individual mandate as the death of the American experiment were endorsing the idea as recently as 2009 — during the debate over reform.
But in case anyone thought to take the faux-outrage seriously, Simon Lazarus raises an important observation: the highly-touted House GOP budget plan, as shaped by Paul Ryan, includes a health care mandate, too. In fact, it includes more than one.
The Ryan budget would reshape Americans’ access to health insurance mainly through two provisions, both of which pressure people to purchase private health insurance to an extent and through mechanisms that are materially indistinguishable from the supposedly toxic Obamacare mandate. One of these Ryan budget proposals — as yet little noticed by pundits or politicians — is almost an exact copy of its equivalent in the Affordable Care Act. […]
Under both provisions, the result is the same: People who choose to carry health insurance have a lower tax bill than they would if they chose not to. In terms of their respective potential impact on individuals’ bank accounts and tax liability, the manner in which they affect individuals’ financial incentives, and hence the constraining effect on individuals’ financial choices to either buy or forgo health insurance, the two “mandate” provisions are identical. (Indeed, in most cases, the financial difference for the individual taxpayer made by the Republican tax credit would be greater — i.e., more “coercive” — than the ACA tax penalty.)
In addition to cloning the ACA’s framework for coverage of adults under 65, the Ryan budget would also apply a similar approach to Americans currently covered by Medicare. Beginning in 2021, former Medicare-eligibles would receive a voucher they can apply to the purchase of private insurance. According to the Congressional Budget Office, the vouchers would be worth approximately $6,000 for recipients age 65, and would be greater for older recipients, averaging $11,000 across the entire Medicare population. Of course, Americans would be required to continue to pay their annual Medicare tax throughout their working lives. Hence, the Republicans’ proposal to replace Medicare with partially subsidized private insurance also operates to “compel” people to pay for private health insurance policies. Moreover, this mandate is not even a pay-or-play option; Medicare taxes are mandatory, whether workers want to buy eligibility for old-age vouchers or not.
Nearly every member of the House Republican caucus voted for this budget plan, and said nary a word about the freedom-crushing provision included by Paul Ryan.
Ezra Klein added, “It’s not surprising, of course, that Republicans are still coming up with ideas that are similar in execution and intent to the individual mandate. The individual mandate, after all, was a Republican idea…. They’ve not come up with anything better in the past few years, and so they’re awkwardly trying out new variants of the individual mandate even as they fight the mandate itself in the courts.”
For a political establishment obsessed with “flip-flops,” this should arguably be considered a reversal for the ages.
