The Affordable Care act is not a “mandate.” It’s government paying for your private insurance when your employer doesn’t.

What’s a synonym for “mandate plus a subsidy”? Government buys you insurance, with a small contribution. Let’s put it the second way.

My post on why the ACA will become popular was too long and confusing.  Shorter me:

The phrase “individual mandate,” though it explained to wonks how we were going to achieve near-universal coverage, was always bound to make for atrocious framing.  Pairing it with a subsidy is great policy but possibly even worse framing.  Now one thing people don’t like—being told by the government what to do—is supposed to be made better by another thing they don’t like—admitting they need government help.

Here is another way of describing ACA that’s completely accurate but explains the point much better:

“If you or your family aren’t getting health insurance through your job, the government will pay to get you private insurance coverage, just as an employer would.  You’ll have to contribute something—but the law guarantees, with specific numbers, that it will be no more than you can afford. It’ll be less than three percent of your paycheck if your family makes $33,000 a year, less than ten percent if you make as much as $88,000.  Pre-existing conditions won’t matter.  The government will still pay for your insurance, with the same affordable contribution from you.”

The bill has lots more—things that make it even better.  But that, it seems to me, is the basic idea.  And if we drill it in, people (Fox News junkies aside) will stop imagining that the bill is somehow about government telling people without insurance that they have to get it because the government won’t help them.  It’s the opposite.  Under ACA, it’s the government’s job to get you insurance, and to pay for almost all of it if you can’t afford it.  Before, you were on your own.

Objections?  Can we sink the “mandate” language once and for all?  And can anyone explain to me whether (or why) anybody ever though “individual mandate” sounded good politically?

Author: Andrew Sabl

I'm a political theorist and Visiting Professor (through 2017) in the Program on Ethics, Politics and Economics at Yale. My interests include the history of political thought, toleration, democratic theory, political ethics, problems of coordination and convention, the realist movement in political theory, and the thought of David Hume. My first book, Ruling Passions: Political Offices and Democratic Ethics (Princeton, 2002) covered many of these topics, with a special focus on the varieties of democratic politics and the disparate qualities of mind and character appropriate to those who practice each of them. My second book Hume's Politics: Coordination and Crisis in the History of England was published in 2012; I am currently finishing a book on toleration, with the working title The Virtues of Hypocrisy, under contract with Harvard University Press. A Los Angeles native, I got my B.A. and Ph.D. from Harvard. Before coming to Yale I taught at Vanderbilt and at UCLA, where I was an Assistant, Associate, and Full Professor; and held visiting positions at Williams, Harvard, and Princeton. I am married to Miriam Laugesen, who teaches health policy and the politics of health care at the Mailman School of public health at Columbia, and we have a twelve-year-old son.

65 thoughts on “The Affordable Care act is not a “mandate.” It’s government paying for your private insurance when your employer doesn’t.”

  1. bubbly requests:

    April 1, 2010 at 3:46 pm

    "Person of Choler what unpleasant consequences are you referring to? How has this affected your life personally? Please show us the trauma that’s unfolded in your life since the passing of the bill."

    For the record, I said "unpleasant" which does not mean "traumatic". Please eschew hyperbole.

    As far as immediate unpleasantness, the company that I work for and hope can pay me the pension that I have worked 36 years for just had to write off several hundred million bucks worth of value they were carrying on their books as a direct result of one little provision in Obamacare. This means less money for employees or shareholders (i.e. pension plans) or higher prices for customers which depresses sales and decreases income.

    The rest of the goodies (including the stuff that got "snuck in": http://www.youtube.com/watch?v=0KKkrPDNBSg) kick in 2013 and 2014.

  2. "The Affordable Care act is not a “mandate.” It’s government paying for your private insurance when your employer doesn’t."…

    WRONG! Ever so very wrong!

    One has to suspend critical thought and disbelief if one were to swallow what Sabl is selling in this posting…

    Its productive citizens having more of their money extorted by federal government to prop up the societal parasites that voted Obama into office…

    Rep. Dave Camp explains the Timeline of the Democrats Healthcare Package

    Ben Franklin noted the following: "When the people find that they can vote themselves money, that will herald the end of the republic"

  3. What your suggesting is either petty or missing the facts or both, if nothing is done your coverage will change at the whim and mercy of the insurance coverages; fact.

    You have no say in what your insurance costs do or do not do.

    This year all insurance plans prices hiked, some as much as 30%.

    If we (government) doesn't start acting to protect ourselves, what do you propose to do? If we (government) don't help ourselves, who will?

    There is a lot of talk about smaller government, or less government, which is a false argument.

    You have either government that works or doesn't. Until we live in a world filled with angels and good intentions, we have to use a social contract to get things done. Only together can we make a difference.

    It's amazing how people are so willing to get off their own nose to spite their face. Well it's my face too, so if I have a chance, I'm going to stop you.

  4. "For the record, I said “unpleasant” which does not mean “traumatic”."

    That's right you did. And there is a big difference, I agree. And it is for this very reason I said traumatic. Unless this effects you traumatically, what reason could you possibly have to spend your time focusing negatively on a bill that doesn't truly effect you personally? In other words, step the hell aside so that people who are traumatically and drastically, negatively and horrifically effected by the shitty health care insurance industry in this country get the help they need.

    None of us who have felt this pain don't care that you find it unpleasant. This is my government too, and I want my family to be covered whether I lose my job or not, I want cheaper drugs and services just like the rest of the ENTIRE FUCKING WORLD, and I don't want my representational government having to fight misinformation and lies spread by a hugely rich health care industry and random idiots like yourself just so they can pass an insurance bill of rights.

    While I have no idea what you're talking about when you ALLEGED "the company that I work for…had to write off several hundred million bucks worth of value they were carrying on their books as a direct result of one little provision in Obamacare," I'd love a little more detail. Please explain that statement, what do you mean written off? Why was their several million bucks lying around to write off? How has it affected you personally and what company do you work for?

    When reflecting upon yourself as to how something effects you, if you have to make up a scenario that currently doesn't exist, then move the fuck on. Because many of us in this country understands what the problems is, has been personally effect by it, and this bill is the first only step EVER to be taken to resolve that problem.

    And as far as you being worried about stuff "sneaked into" the bill, once again you need to explain what stuff hurts you personally. List out the stuff you think was "sneaky", then explain which is important to you and why.

  5. I love ken! He's grasped the essence of Obamacare. Fuck the kids. Insure MEEEEEEEEEE! Make someone else PAAAAAAY!

  6. Hey Andrew,

    I don't have health insurance, because I chose not to buy it. I am a healthy individual, and I have better things to spend my money on than betting against my continued good health.

    If the government forces me to buy health insurance anyway, that's a mandate.

    Since you seem a little slow, let me give you an analogy that even you should be able to understand:

    If an old lady wants to cross the street, and a Boy Scout helps her cross it, he's assisting her.

    If an old lady is standing on a corner, simply enjoying the sunshine, and a Boy Scout comes along, grabs her arm, and drags her across the street, he is not assisting her, he is not helping her, he has not done a good deed. Especially since she was waiting to meet some friends, and they were planning on meeting at that corner.

    The ACA is an example of the second kind of "help". The American people are intelligent enough that they have figured that out. Which is why health insurance "reform" is unpopular, why it will remain unpopular, and why the Republicans are going to take back the House and the Senate in November.

  7. If you don't have car insurance Greg Q but still drive a car, who pays when you get in an accident?

    THAT"S RIGHT!

    So unless you can change the way the world works, you will now have to have insurance! YEA!

  8. Person of Choler Kenton Kelly isn't above lying or distorting the facts either being the good little Republican that he is. You should take what he says with a very large grain of salt.

  9. bubbly, as to ignoring laws that one doesn't like because they don't affect one personally: You might as well ask why white northerners fought against Jim Crow laws that affected people they would never see in places they would never visit. I dislike Obamacare because I think the huge costs and governmental interference in everyday life are, in the long run, bad for the country. The inequities you cite could have been remedied with much less cost and far fewer regulations.

    As to what the writedowns actually mean I won't our time arguing about that. Read an accounting textbook and look at SEC reporting regulations or ask a CPA for an explanation.

    anon says that Kelly distorts facts. He might, but when he is talking about tax law and accounting requirements, he seems to know what he's talking about and the fact that he may be wrong on other matters does not change that. You might follow the advice to Bubbly: read an accounting textbook. You might prove Mr. Kelly to be wrong. Get back to us if you can.

  10. Person of Cholor,

    You know, of course, that your company merely lost the ability to cheat the taxpayer (are you one?) out of millions of dollars, don't you?

    So yeah, when a loophole that no one (yourself included?) things is unfair is closed we generally don't complain about it.

    Your company is now being treated the same as everyone else. Nothing wrong with that. If this costs you your pension, then it was a pension that wasn't deserved in the first place as it was dependent upon a cash subsidy from the taxpayer to your company instead of on real earnings.

  11. Greg Q

    You should be happen then. There is NO individual mandate in the bill.

    You and the media got suckered by Republican propaganda.

    No one in the GOP can find who is going to punish you and how they are going to do it

    Democrats aren't going to tell you this but it is the fact

  12. Also Sprach ken (April 3, 2010 at 3:21 pm)

    Person of Cholor, [sic]

    "You know, of course, that your company merely lost the ability to cheat the taxpayer (are you one?) out of millions of dollars, don’t you?"

    If taking legal tax deductions is, as you say, cheating the taxpayer, the fault lies with the legislators who passed the law allowing the deduction, not the corporate managers whose fiduciary duty it is to take advantage of such tax breaks.

    In response to your question, I am indeed a taxpayer and would actually be happy if all loopholes were closed and the tax system were to be greatly simplified. The loopholes distort corporate and individual decision making. Companies devote to the tax-avoidance game too many resources that ought to be applied to product development and customer service.

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