Nov. 19: A look at key issues in the health care debate:
THE ISSUE: Should every person be required to either have health care insurance or pay a penalty tax?
THE POLITICS: Requiring everyone to buy health insurance can help spread the responsibility for medical costs. With proposed subsidies to help the poor buy in, the so-called “individual mandate” gets Democrats closer to moving millions of uninsured into coverage plans. Insurance companies are largely on board, though they have raised fears that a Senate version of the health bill doesn’t impose stiff enough penalties to ensure that people actually comply.
Insurers say the mandate, covering everyone so they can’t seek insurance just when they are ill, could bring concessions from them on other issues. An example: Acceptance of all, regardless of pre-existing health status.
President Barack Obama did not support an individual mandate in his campaign, but now says his thinking has evolved. Critics on the left say the plan leaves out lower-middle-class people who aren’t poor enough for a subsidy but will struggle to pay for insurance even if some exceptions are granted.
WHAT IT MEANS: Individuals who don’t have health insurance through employers or another group would have to purchase it, either privately or from any public plan Congress creates. Ignoring the mandate would bring a penalty fine. Democrats propose taxpayer-supported subsidies for the lower-income who can’t afford insurance, though concerns have been raised about whether those subsidies are generous enough; if not, some people could find it cheaper to forgo coverage and pay the penalty instead. Proponents of the individual mandate say among the cost problems it would solve is the hospital and taxpayer burden of the uninsured who use emergency rooms as their primary care when they’re sick.