The Corner

Politics & Policy

Carly Fiorina and Health Care

In 2013, Fiorina went on CNN and was asked if she supported two provisions of Obamacare: its individual mandate and its ban on discrimination by insurers against people with pre-existing conditions. She said she favored both provisions, but opposed Obamacare as a whole. Her campaign says that she supported the conservative Heritage Foundation’s plan, which included an individual mandate.

This could be a problem for Fiorina because the individual mandate is among the least popular features of the law, especially among conservatives, who tend to think that the mandate is unconstitutional. (Several Supreme Court justices agree; and note that Fiorina’s remarks came after that Supreme Court case, so she should have been aware of the controversy.) The pre-existing conditions provision, by contrast, is among the law’s most popular features–but it’s closely tied to the mandate. The mandate is in large part in the law because of the ban. Health policy experts worry that without a mandate, the ban would make it possible for people to wait until they’re sick to buy insurance. Markets in insurance can’t work if everyone adopts that behavior. So if insurers have to treat the healthy and the sick alike, requiring healthy people to buy insurance–or some similar policy–becomes necessary.

My free advice to Fiorina would be to run away from these policies, which are fairly central to Obamacare. I assume that what she liked about these policies was that they aimed at expanding the number of people in the insurance pool and at protecting people with pre-existing conditions. She should come out for a health-care plan that does both of those things without mandating that anyone buy insurance. And such a plan is available: She could just pick up the plan Scott Walker released a little bit before he dropped out.

That plan expands the insurance pool by making catastrophic policies more affordable rather than ordering people to buy them. And it protects people with pre-existing conditions without imposing regulations that need a mandate or anything similar to back them up. Some people would still be unhappy that she had ever been for a mandate. But if she came out for a new plan it would, I think, make that history less important.


Ramesh Ponnuru is a senior editor for National Review, a columnist for Bloomberg Opinion, a visiting fellow at the American Enterprise Institute, and a senior fellow at the National Review Institute.

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