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"Sticks" or Mandates to Buy Health Insurance: Is Health Reform Possible Without Them? : The Government We Deserve


In a letter to top Senate Democrats, President Obama recently stated that he was open to the "principle of shared responsibilitymaking every American responsible for having health insurance coverage, and asking that employers share in the costs." This sounds very much like support for what are sometimes labeled individual and employer "mandates," though in the Presidential campaign he opposed requiring adults to buy insurance, except for their children. Done the right way, "mandates" could increase dramatically the numbers of those insured, while helping drive down the rate of increase in health care costs. Done the wrong way, they can be unenforceable or drive up the number of unemployed. The Senate Finance Committee increasingly has been turning to mandates as part of a package of health reform.

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