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President's words on mandate disheartening, worrisome, but not surprising

April 2, 2012 - Mike Maneval
Asked Monday about the Supreme Court's consideration of the constitutionality of the individual health insurance mandate, President Barack Obama said the mandate was constitutional, that an overturning of the 2010 law would be "judicial activism," and that Americans need to understand the issue affects everyone and is not some "abstract argument," in his words. But that isn't all he said.

"I think the justices should understand that in the absence of an individual mandate, you cannot have a mechanism to ensure that people with pre-existing conditions can actually get health care," Obama said, according to

It is disheartening to hear the president cave in to the viciously anti-consumer "logic" that individuals will wait until affliction before purchasing a health insurance policy. Disheartening, but not entirely surprising: Obama already had reversed his position on the issue from the 2008 campaign, when he told rival for the Democratic nomination and then-Senator Hillary Clinton of New York that the number of uninsured was produced by the unaffordability of health insurance, not some nefarious plot by consumers to withhold payment from an insurer until expenses had begun to accrue. He reversed his position from that campaign when he signed a law requiring Americans to buy a product in which they simply may have no faith.

It also is a worrisome trend, as many pundits try to frame the issue as an achilles heel to the law. Opponents of the law want the public to believe that were the requirement to buy an insurance policy - the least-defensible aspect of the law - overturned, its remaining parts no longer would work. It is a position that is pure speculation, and the sort of speculation that when used by proponents of health care reform, undermines the behemoth law's best features. Features such as better protection for insurance consumers and a state and regional exchange program that could alleviate strain on insurance markets.

The "logic" displayed by the vituperative claim large numbers of consumers plan with forethought to bilk coverage through delayed enrollment - the sort of claim that if made about the motives of an entrepreneur or investor would quickly be labelled "class warfare" - could yet be a self-fulfilling prophesy. If the courts overturn the mandate, either the Supreme Court or the legislators now can point to the president's own words to justify striking other portions of the law, leaving consumers to pay for policies that fail to provide services under the fallacy of "pre-existing conditions."

And that risk may be the most worrisome consequence of the president's words on Monday.


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