|Connie Cass; Connie Cass The Associated Press|
People are split over the wisdom of
Nonetheless, Americans don't like being told how to spend their money, not even if it would help solve the problem of the nation's more than 50 million uninsured.
Can the government really tell us what to buy?
Federal judges have come down on both sides of the question, leaving it to the
Their ruling, expected in June, is shaping up as a historic moment in the century-long quest by reformers to provide affordable health care for all.
Many critics and supporters alike see the insurance requirement as the linchpin of Obama's health-care law: Take away the mandate and the wheels fall off.
Politically it was a wobbly construction from the start. It seems half of
One critic dismissed the idea this way: "If things were that easy, I could mandate everybody to buy a house and that would solve the problem of homelessness." That was Obama as a presidential candidate, who was against health insurance mandates before he was for them.
Once elected, Obama decided a mandate could work as part of a plan that helps keep premiums down and assists those who can't afford them.
To hear Republicans rail against this attack on personal freedom, you'd never know the idea came from them.
Its model was a
So much for compromise.
Obama and congressional Democrats pushed the mandate through in 2010, without Republican support, in hopes of creating a fair system that ensures everyone, rich or poor, young or old, can get the health care they need. Other economically advanced countries have done it.
Doing nothing is more expensive than most people realize.
The overhaul is neither the liberal dream of a single government program supported by taxes and covering everyone nor the conservative vision of stripping away federal rules and putting free enterprise in charge.
The Obama plan relies on private companies plus lots of regulation to make sure they provide basic benefits, keep premiums reasonable, and cover the sick as well as the healthy. That's where the mandate comes in. If insurers must cover everyone, even those with existing medical conditions, healthy people have little incentive to sign up before they get sick.
Insurance companies argue that if only the sick sign up, insurers will go broke. So the law says everybody must have insurance for themselves and their children, or pay a penalty.
Also, because everyone needs health care sometime, if everyone purchases insurance, the price per person can be lower, with the cost of care spread out over many people.
After all, the government requires workers to pay
One argument for the insurance mandate is that the fines are just federal taxes by another name. Another is that it falls under the government's constitutional power to regulate commerce that crosses state borders.
State governments, of course, tell people to buy lots of things, including auto insurance or motorcycle helmets.
"You can always move to another state," said
In an Associated Press-GfK poll, 85 percent said the U.S. government should not have the power to require people to buy health insurance. When the question is worded without the specific reference to federal power, acceptance of the mandate grows a bit, but 6 in 10 are still against it.
Even among those who generally support the health-care overhaul, one-third said they are against the insurance mandate.
There's also a significant minority who sees mandates as a cop- out and prefer a government program that covers everyone,
It's clear that many people do not understand what the law would do or how it would affect them.
"If I can't put food on the table for my children, how can I pay for health-care coverage?" asks Gonzales, who's been without insurance for seven years. "What moron came up with that idea?"
Of course, she might qualify for the law's exemptions for those too poor to pay and for assistance for low-income people, as well as many in the middle class.
There also are some religious exemptions.
Estimates vary widely of how many uninsured people will get insurance once it's required in
About 4 million people would pay a penalty to the
By 2016, the fine reaches
That leaves insurance companies, who stand to gain lots of new customers, worried that people instead will shrug off the weak mandate.
Meanwhile, the state-federal
Health care law: www.healthcare.gov
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