Editore"s Note
Tilting at Windmills

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May 4, 2011

REMEMBER HOW MUCH REPUBLICANS HATE THE INDIVIDUAL MANDATE?.... If there's one thing GOP officials agree on when it comes to the Affordable Care Act, it's their disgust for the individual mandate. Never mind the fact that the mandate was their idea, Republicans have labeled this provision of the health care law to be an outrageous, un-American assault on liberty. In some conservative circles, it's downright tyrannical.

Now, any serious person listening to the hysteria has to realize Republicans don't actually mean any of this. Indeed, many of those characterizing the individual mandate as the death of the American experiment were endorsing the idea as recently as 2009 -- during the debate over reform.

But in case anyone thought to take the faux-outrage seriously, Simon Lazarus raises an important observation: the highly-touted House GOP budget plan, as shaped by Paul Ryan, includes a health care mandate, too. In fact, it includes more than one.

The Ryan budget would reshape Americans' access to health insurance mainly through two provisions, both of which pressure people to purchase private health insurance to an extent and through mechanisms that are materially indistinguishable from the supposedly toxic Obamacare mandate. One of these Ryan budget proposals -- as yet little noticed by pundits or politicians -- is almost an exact copy of its equivalent in the Affordable Care Act. [...]

Under both provisions, the result is the same: People who choose to carry health insurance have a lower tax bill than they would if they chose not to. In terms of their respective potential impact on individuals' bank accounts and tax liability, the manner in which they affect individuals' financial incentives, and hence the constraining effect on individuals' financial choices to either buy or forgo health insurance, the two "mandate" provisions are identical. (Indeed, in most cases, the financial difference for the individual taxpayer made by the Republican tax credit would be greater -- i.e., more "coercive" -- than the ACA tax penalty.)

In addition to cloning the ACA's framework for coverage of adults under 65, the Ryan budget would also apply a similar approach to Americans currently covered by Medicare. Beginning in 2021, former Medicare-eligibles would receive a voucher they can apply to the purchase of private insurance. According to the Congressional Budget Office, the vouchers would be worth approximately $6,000 for recipients age 65, and would be greater for older recipients, averaging $11,000 across the entire Medicare population. Of course, Americans would be required to continue to pay their annual Medicare tax throughout their working lives. Hence, the Republicans' proposal to replace Medicare with partially subsidized private insurance also operates to "compel" people to pay for private health insurance policies. Moreover, this mandate is not even a pay-or-play option; Medicare taxes are mandatory, whether workers want to buy eligibility for old-age vouchers or not.

Nearly every member of the House Republican caucus voted for this budget plan, and said nary a word about the freedom-crushing provision included by Paul Ryan.

Ezra Klein added, "It's not surprising, of course, that Republicans are still coming up with ideas that are similar in execution and intent to the individual mandate. The individual mandate, after all, was a Republican idea.... They've not come up with anything better in the past few years, and so they're awkwardly trying out new variants of the individual mandate even as they fight the mandate itself in the courts."

For a political establishment obsessed with "flip-flops," this should arguably be considered a reversal for the ages.

Steve Benen 9:45 AM Permalink | Trackbacks | Comments (11)

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Comments

Lying?
Inconsistant?
Or, hypocritical?

I say it's the trifecta.

Remember when everyone used to say that the Republicans were the "Idea Party?"

Yeah, and it's still the same old idea's in that party.

Posted by: c u n d gulag on May 4, 2011 at 9:48 AM | PERMALINK

For a political establishment obsessed with "flip-flops," this should arguably be considered a reversal for the ages.

Yes, today actually. I heard FOX News will be running stories informing Tea Nation about this House vote to mandate purchasing of private insurance (x2), and how unconstitutional it all is. Armed with this information, Tea Nation will be taking freedom cries to the streets and town halls of America. Then again, maybe FOX News is just a hyper-propaganda arm of an increasingly unabashedly fascist political party.

Posted by: AndThenThere'sThat on May 4, 2011 at 10:21 AM | PERMALINK

We can chortle all day long (and that's what we usually do) about Republican hypocrisy but that's how they play the game: aggressively. We play the game to bend power to justice, which means using government effectively in service of that goal. Winning is important but it can't be the goal itself. But for Republicans, it's virtually the only thing that matters. Ultimately, people will have to decide what's most important in their lives: identifying as a "winner" or behaving like a citizen. I'm not confident they'll choose wisely but it's their nation to do as they will.

Posted by: walt on May 4, 2011 at 10:27 AM | PERMALINK

One of these Ryan budget proposals -- as yet little noticed by pundits or politicians -- is almost an exact copy of its equivalent in the Affordable Care Act. [...]

*************

err ........maybe somebody could point this out to the ejaculating corporate media concerning Ann Rand = Paul Ryan ?

Posted by: stormskies on May 4, 2011 at 10:58 AM | PERMALINK

It's not a flip-flop, it's a calculating plan to eliminate Medicare entirely.

If you turn Medicare into a mandate, and then the Supreme Court declares mandates unconstitutional (which at least some federal judges are prepared to go along with) then that's the actual end of Medicare, not just the end of Medicare as we know it.

Posted by: Mike from Detroit on May 4, 2011 at 11:37 AM | PERMALINK

"the vouchers would be worth approximately $6,000 for recipients age 65, and would be greater for older recipients, averaging $11,000 across the entire Medicare population. "

This needs to be shouted loud and clear from the rooftops. Then ask people where they can buy medical insurance that is the equivalent of Medicare for a crummy $6,000 a year. That would barely cover a 30 year old in perfect health with no preexisting problems. The amount that the retirees would have to make up out of their own pockets is enormous. Let people know about it.

Posted by: Texas Aggie on May 4, 2011 at 11:40 AM | PERMALINK

I just did a Google search of what it would cost a 30 year old to get medical insurance. It isn't the premiums that are going to kill you. It's the co-pays and deductibles that are going to do it. I would suspect that it would even be worse for an older person, especially one who had some sort of chronic problem that needed constant medical care. Atrial flutter comes to mind, as do high blood pressure and diabetes.

Posted by: Texas Aggie on May 4, 2011 at 11:52 AM | PERMALINK

This is why the status of our politics is so depressing. I don't like the Paul Ryan plan, but in a rational time, you would think this was at least the catalyst for a deal. You could envision a "lifelong" insurance plan coming out of this, with adjustments to ensure that any voucher system, whether below age 65 or above age 65, would be flexible to handle most insurance needs for all Americans.

But this won't happen. The Republicans won't even acknowledge the similarities, and won't even budget off their reflexive "repeal" strategy.

Posted by: Chris on May 4, 2011 at 11:54 AM | PERMALINK

But it's OK, because Paul Ryan is a serious man. And white. And has great hair. And that means that anything which comes from his serious. And white. And has great hair.

Or something,
-Z

Posted by: Zorro on May 4, 2011 at 11:58 AM | PERMALINK

The more startling fact about the GOP plan to reduce the deficit is that it doesn't reduce the deficit.

Wouldn't it be great if anyone noticed that.

Posted by: Burr Deming on May 4, 2011 at 12:59 PM | PERMALINK

Oh Snap! This is huge. My Republican and/ or Tea Party friends were left speechless when I pointed this out to them today.

Remember the old analogy about the stool that topples if you only remove one leg out from under it? Well this leaves leaves nothing but the round seat lying flat on the floor:
Leg one - Individual Mandates (IMs) were originally a GOP idea.
Leg two - IM's are the primary vehicle being used by the states to make ACA illegal, unenforceable and would allow people to avoid getting insurance until they need it.
Leg three - The House GOP (and soon the Senate GOP) just voted almost unanimously to utilize that which they claim is illegal and even unconstitutional.

What are the GOP congressmen going to say in their defense, that they didn't read Ryan's plan before voting on it?

The look on my friends' faces was priceless and totally made my day! What a great week to be a liberal after OBL's demise.

Posted by: Kiweagle on May 4, 2011 at 1:44 PM | PERMALINK
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