John R. Graham argues in the comments that the mandate won’t lead to a death spiral, because the mandate only applies to higher-income people, most of whom already have insurance. Plus, he thinks the limited open enrollment period in the new exchanges will sufficiently discourage gaming. Dean Clancy also thinks it’s not problematic to eliminate the mandate now, because it doesn’t go into effect until 2014. Mario Loyola argues that “enlarging” the Obamacare problem is a good thing. Reihan Salam thinks I’m right.
John makes the strongest pro-repeal arguments, in my view, in that he could be right that the mandate has less impact in reality than in theory. However, the capital markets will kill the HMO stocks in the near term, and it’s simply not good business practice to introduce the risk that the private insurance market could go completely away if the GOP doesn’t win the 2012 elections. As some other commenters have pointed out, destroying the private insurance market is a dream outcome for the Left.
Mario asks “whose problem” is it that a partial repeal would destabilize the private insurance market: I would respond that it would be a problem for everyone who has private health insurance. We have to remember that real people will be adversely affected by a massive disruption of the existing system, that it’s not merely about winners and losers in Washington. I don’t think he’s right that Republicans would avoid blame for a provision that they actively negotiated for.
And I’m of course glad to be on the same side as Reihan, my blogging mentor.