Mark Blumenthal | December 15, 2009
Last night's news that Senate Democrats have agreed to abandon both a government run public option and a Medicare buy-in provoked a storm of criticism from the Netroots left. Markos Moutlisas (the Kos of DailyKos) tweeted a desire to "kill" the Senate bill and later explained that his main objection is the mandate on individuals to purchase health insurance: "My position on #HCR -- kill it if it includes mandate. Strip out the mandate, then what's left is inoffensive."
The irony in this latest twist in the health reform debate is that Obama's opposition to individual mandates was the key point of differentiation with Hillary Clinton on health care reform during campaign 2008. This new turn will inevitably draw more attention to an aspect of the reform bill that has received surprisingly little attention so far.
So it's probably worth reviewing what surveys can tell us about public opinion regarding an individual mandate.
Not surprisingly, the monthly tracking surveys done by the Kaiser Family Foundation have some of the most useful data. Their November tracking survey finds 72% of Americans in favor or "requiring all Americans to have health insurance, either from their employer or from another source, with financial help for those who can't afford it" (39% say they favor the idea strongly, 25% are opposed). Support on their tracking surveys has ranged between 66% and 72% over the last 12 months.
However, just last month the Kaiser pollsters demonstrated just how tenuous that positive reaction might be. When the informed those in favor that an individual mandate "could mean that some people would be required to buy health insurance that they find too expensive or did not want," support plummets to just 21%.
So this data takes us back to the main point explored in my column earlier this week. To those in the middle on health reform, affordability is the key word. Requiring that everyone buy affordable insurance sounds mostly inoffensive. Requiring people to buy coverage that is too expensive could prove to be a very unpopular proposition. The real impact that this proposal will have on the cost of insurance is what should be the focus. That's the subject of Nate Silver's analysis this morning and is a worthy subject for further discussion and debate.