The Mandate Miscalculation

Obama’s health care blunder—and how to fix it.
  1. Democrats didn’t see it coming: Before the passage of the Affordable Care Act in 2010, neither congressional leaders nor the White House anticipated that one specific provision—the mandate requiring individuals to maintain a minimum level of health insurance—would spark such a ferocious political and legal backlash. Yet, nearly two years later, controversy surrounding the mandate dominates the national conversation about health care reform. The constitutionality of the mandate is the central issue in the legal challenge to the Affordable Care Act, which the Supreme Court will take up this March. And overturning the mandate has provided a rallying cry for Republican opposition to President Obama.

    The story of the individual mandate is replete with ironies. Obama spent much of the 2008 primary season denouncing the mandate, which Hillary Clinton supported. At the time, Mitt Romney was strongly identified with the idea, which had been central to the reforms he introduced as governor of...

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