Maybe the Mandate Is No Big Deal
Paul Starr, a professor of sociology at Princeton, notes that the government has little power to enforce the fines. It can’t impose criminal sanctions or liens on the property of those who do not comply. It can’t garnish their wages. The most it can do is withhold their tax refunds. Mr. Starr says he believes that in the end, the mandate will largely be ignored.
More on this provision in the Affordable Care Act in the NYT.
I think Starr is correct. Without the ability to enforce the mandate, people will wait until sick to sign up for coverage. Moderate-income people will qualify for generous subsidies, but not paying any premiums until you become ill is an even bigger subsidy.
Starr had some good ideas in his article, and I think he hits the nail on the head when it comes to his predictions of the likely outcomes of this fight.
The policy community has debated what would happen if the individual mandate is struck down but the insurance regulations were left to stand. Many policy experts believe the Supreme Court should strike down the entire law if it strikes down the mandate. The reason is because of the nature of the so-called 3-legged stool (i.e. the individual mandate, generous subsidies and insurance regulations requiring insurers to cover all applicants without adjusting for risk) would fall apart without the mandate.
This raises another interesting concept. What if the Supreme Court lets the entire law stand and the mandate is not enforced? At least if the mandate is struck down, the policy community knows something must be done since the law requires all three elements. But, if the mandate is merely ignored, the insurance market could disintegrate regardless of the Supreme Court.
Interesting.
I have been wondering precisely about this. If the entire law stands, and the mandate gets ignored (as the author predicts), then what?
I think I know what. Some future, progressive administration (President Rahm Emanuel?) will take the next step to strengthen federal health care. In other words, it won’t end with this legislation. This is going to go on for decades and they (the progressives) won’t stop until they get single-payer-universal health care.
Ignore the mandate? Sounds good to me. And one can avoid losing money out of their tax return by calculating it correctly in the first place, right?
Maybe the government can’t enforce the mandate now, but give it time. Also expect that the fine will go up, up, up as it has in Massachusetts.
Perhaps a future president could simply ignore three enforcement of the mandate, just like the current president is ignoring the enforcement of certain immigration laws.