The mandate is a poison pill
by Jerome Armstrong, Mon Dec 21, 2009 at 07:03:26 AM EST
Jon Walker closes this post with a sound idea:At the very least, remove the individual mandate so it can be held as a bargaining chip by progressives to extract greater reforms between now and 2015, when the mandate would go into effect. Passing the individual mandate now (just so it can sit on the books for years) would be a political and negotiating disaster for Democrats. As it looks now, the next reform battle will be fought on the terms of the insurance companies even more. That is not what I think is a step forward.It's painfully obvious that there are no talking points available to Democrats to attempting to defend the mandate. Its maddening to attempt to figure out why Democrats are intent on imposing a mandate now, enforceable by IRS penalties, that doesn't go into effect for 5 years, only to get clubbed with it for the next three cycles.
A recent national poll done by DFA/PCCC found very the majority of voters opposed to the mandate in its current form by a 56 - 33 margin.
When Jane Hamsher posted about the DFA/PCCC findings as fairly conclusive, Nate Silver objected. He questioned the political negativity of the mandate by stating that the DFA/PCCC question was worded uncharitably toward the mandate, and that a Kaiser poll with charitable wording showed just the opposite of numbers (implying inconclusive findings).
Here's the "uncharitable" wording of the DFA/PCCC poll in question:Would you favor or oppose requiring all Americans to buy health insurance -- the so-called mandate -- even if they find insurance too expensive or do not want it? Favor 38 Oppose 51
Here's the "charitable wording in a poll done by Kaiser:Would you favor or oppose requiring all Americans to have health insurance, either from their employer or from another source, with financial help for those who can't afford it? Favor 66 Oppose 31
Well, that's quite a contrast, but there's an important component of the Kasier poll that Silver left out. The next question of the Kaiser poll, asked only to those who said they favor the mandate, was worded:"What if you heard that this could mean that some people would be required to buy health insurance that they find too expensive or did not want?" Still Favor 21 Now Oppose 73
Support drops dramatically. But something else becomes clear when comparing the wording of the single PCCC/DFA question with the two Kaiser polling questions:PCCC/DFA question:
"Would you favor or oppose requiring all Americans to buy health insurance -- the so-called mandate -- even if they find insurance too expensive or do not want it?"
"Would you favor or oppose requiring all Americans to have health insurance, either from their employer or from another source, with financial help for those who can't afford it?"
"What if you heard that this could mean that some people would be required to buy health insurance that they find too expensive or did not want?"All the DFA/PCCC poll question did it seems, is combine the two questions asked by Kaiser. The only difference is that the DFA/PCCC question in the poll includes "the so called mandate" wording. Whatever. If someone wants to argue on behalf of the mandate having a PR headache for Democrats, that fine, but stop with the insinuations that calling it what we have all called it, a mandate, or an individual mandate, involves bias.
And besides, Jane Hamsher's obvious point wasn't that the poll could be no less neutrally worded, but that the political framing of the mandate would be much more toxic than this poll's question, ie., "When it appears in the ads of a Republican challenger who notes that the IRS will act as Aetnas collection agency, I bet those numbers get dramatically worse."
And that it will. The simple follow-up question on the Kaiser poll turned the favorable numbers above, into a rout of opposition, with 80% opposed and just 18% in favor of the individual mandate to buy insurance.
This is really the point. Who really cares what is the most neutral wording of the poll? Are voters ever going to be presented with a neutral take by either party in ads and message from the candidates? No way now how.
So what we really want, is a further follow-up question that asks the inevitable '10/'12/'14 rightwing framing of the mandate to those 18% still in favor:
'What if you heard the individual mandate to buy private insurance is enforced by fines from the IRS acting as a collection agency on behalf of Aetna?'
'What if you heard the individual mandate to buy insurance is a bailout/giveaway/gift to private insurance companies?'
'What if you heard the individual mandate to buy private insurance is a disproportionately impacts lower-income families?'
And who can imagine what more are available. And yet there was Nate Silver in another recent post titled: "Why Progressives Are Batshit Crazy to Oppose the Senate Bill" where he argued: ... frankly, the individual mandate penalty is not very harsh ...if you adopted the House bill's subsidies for families at under 250% of poverty, and the Senate's (which actually become more generous) for people at greater than 250% of poverty -- perhaps in exchange for a harsher (not weaker!) individual mandate penalty -- you'd have a pretty reasonable compromise.Wow, that turns compromise into suicide-- and he's calling others crazy?
How are proponents of the mandate going to deliver the effective rebuttal to the attack on the mandate? Maybe its the the Kaiser follow-up guilt-question to those who opposed it is the answer (... deny coverage to the sick)? Whatever it is, Debbie Wasserman-Shultz, Ezra Klein, and a whole Senate of Democrats that just voted for the mandate, could sure use it. And it won't be reality-based either, but instead a response to fear-mongering tactics for the next 5 years.
At the least, Democrats should get rid of the few-hundred dollar fines of the IRS associated with the mandate. If $1.2 Billion was available in the Manager's amendment to get the votes of Nelson and the others, then surely, can't the feeble amount collected by the IRS can be taken off the bill in an effort of toxic clean-up? And assign some sort of trigger to the mandate, that only becomes binding upon actual reform. Without some overhaul of the mandate in HRC, its a poison pill.
Nate Silver's latest claim is that removing the mandate would increase the CBO score, which is taken on by Jon Walker who points out just the opposite, Removing The Individual Mandate Would Reduce The CBO Score.
I doubt the deal changes much. But, it'll be interesting to see further breakdowns of the poll numbers regarding the mandate. I think it will only become more toxic overall, and the bulk of the response will be damage-control and on the defensive (you don't have to pay the IRS fine, OK!). But specifically, I'd like to see some numbers on voters and non-voters, and whether a person who has insurance or not (the ones effected by the mandate) is a voter, and what sort of breakdowns happen (this is one of those issues where libertarian impulses cross all sorts of barriers). That would begin to give the outlook some perspective of political fall-out.