Comment & Debate
David Orentlicher. “An Individual Mandate to Purchase Health Care Insurance Is Constitutional.” Huffington Post. December 14, 2009: “the health care legislation before Congress constitutes an important effort to regulate the health care insurance industry. Key elements of the legislation are the provisions that prohibit insurers from denying coverage or raising prices because of a person’s “preexisting” medical conditions. Under current industry practices, many people cannot obtain health care coverage because they have heart disease or other medical problems that cause insurers to refuse coverage or charge higher premiums. The House and Senate bills would prohibit these denials and higher charges so everyone can purchase affordable coverage. […] But insurers cannot be asked to eliminate the higher charges unless everyone is required to have insurance. Otherwise, many people would wait until they became sick before buying coverage. In short, the individual mandate is a necessary component of the effort by Congress to protect people from unaffordable health insurance premiums. And under the Constitution, Congress is entitled to ‘make all laws which shall be necessary’ for carrying out its commerce clause and other enumerated powers.”
Democratic House Majority Leader Steny Hoyer said in November of 2009: “Well, in promoting the general welfare the Constitution obviously gives broad authority to Congress to effect that end. The end that we’re trying to effect is to make health care affordable, so I think clearly this is within our constitutional responsibility.”
“Liberals go off on a mandate.” The Economist. December 17th, 2009: “You cannot have universal health insurance without a mandate. Every country in the world that has a universal health-insurance system either requires its citizens to buy health insurance, or includes its citizens in a default insurance programme automatically and taxes them for it (which is effectively the same thing). The reasons for this are simple, and have been covered hundreds of times since the current debate over universal health insurance began during the Democratic presidential primaries in late 2007. If you don’t oblige everyone to buy health insurance, then many young and healthy people will bet on not needing insurance, and will decline to buy it. That shrinks the remaining pool such that it is made up of older, sicker people with higher medical costs, and thus premiums will rise. That in turn will cause more healthy people to leave the system. This is the phenomenon of “adverse selection”. Ultimately you’re left only with rich old sick people, and nobody else can afford insurance. This is known as an insurance death spiral. If you want affordable, universal health insurance, then everyone has to buy in.”