The GOP has promised its base that it will defund the individual mandate, and it has promised health insurance companies that it will strengthen the mandate. Something has to give.
Robert Pear’s NYT story the other day about Republican efforts to repeal health care reform contained this evocative nugget close to the lede.Â The Republicans acknowledge that they cannot repeal the Affordable Care Act because of a Presidential veto, but will try to do it indirectly in other ways:
Republican lawmakers said, for example, that they would propose limiting the money and personnel available to the Internal Revenue Service, so the agency could not aggressively enforce provisions that require people to obtain health insurance and employers to help pay for it. Under the law, individuals and employers who flout the requirements will face tax penalties.
I’d like to see them try.Â Really: I’d like to, and here is why:
Yes, the Tea Party is outraged by the individual mandate.Â Yes, politically ambitious GOP state attorneys general are suing over its constitutionality.Â
But you know who loves the mandate? Health insurers.Â And they poured millions into GOP coffers during the campaign, mainly because they think that they have persuaded the GOP to strengthen the mandate.
And you know who doesn’t love the mandate?Â Barack Obama. Recall that during the presidential campaign, he criticized Hillary Clinton’s plan for including one.Â Apparently, he was (is?) concerned that we’ll get a mandate without adequate subsidies.
If Obama and the Dems play this right, this could leave the House GOP in a bind:
1)Â They insist on defunding mandate enforcement, and they cut off a big contributor constituency; or
2) They back off from defunding mandate enforcement, enraging the Tea Party and generating dozens of primary challenges; or
3) They insist on defunding mandate enforcementÂ and Obama agrees.Â If there is an agreement, that’s the worst of all possible worlds — any agreement will tick off the Tea Party, and defunding mandate enforcement will tick off the insurers, sticking them with antidiscrimination regs but no mandate.
So obviously, the GOP will try to make their appropriations riders as unappetizing as possible for Obama.Â But then Obama can use his megaphone, saying that he’s ready to back off the mandate and the GOP won’t let him, again splitting the base.Â And why won’t they let him?Â Because they insist on defunding the popular parts of the ACA, like anti-discrimination and anti-rescission provisions.
The weak link on this is that the GOP will try to couple defunding the mandate with defunding the exchanges, which will help working people but no one understands, and thanks to Steaming Pile of Senator Kent Conrad, don’t kick in for a while.Â Still, Obama can say he’s ready to stop the mandate if the GOP is, which it won’t be because the insurers won’t let it.
In all, it will be interesting to see how the GOP will try to continue to serve the insurers while at the same time keeping Tea Partiers off its back.Â It will be able to count on key support from the media, which will lap up its spin.Â But still,Â it’s hard to promise two key constituencies two diametrically opposed things.
The other weak link isÂ the requirementÂ that Obama and the Dems play this right.Â As someone said the other day, these guys couldn’t sell cocaine to Charlie Sheen.Â But the GOP has a problem with this, and Obama’s strategy should be to ensure that as many people as possible know about it.Â Besides, if we get rid of the mandate, then this might actually put enough pressure on the system that we’ll have to have a public option, which would be a great and ironic outcome down the road.