In the Washington Post, Heritage Foundation health-policy scholar Bob Moffit has responded in detail to President Obama’s invocation of Heritage as an originator and supporter of two key elements of his health plan: state-based insurance exchanges and the individual mandate to purchase insurance.
After Moffit distinguished the two version of health exchanges, he addressed the more difficult problem – the fact that Heritage did, indeed, endorse individual health-insurance mandates in the past. Rather than attempt to redefine the problem away, as I have frankly seen some analysts do in the past, Moffit admitted error:
For the record, we think that the law’s federal mandate is unconstitutional. Our legal center, led by former attorney general Edwin Meese III, notes that Congress has no authority to force an American to buy any good or service merely as a requirement of being alive.
Yes, in the early 1990s, we, along with other prominent conservative economists, supported the idea of such a mandate. It seemed the only way to solve the “free-rider” problem, in which individuals can, under federal law, walk into any hospital emergency room nationwide and rack up big bills at taxpayer expense.
Our research in the ensuing two decades has led us to realize our initial idea was operationally ineffective and legally defective. Well before Obama was elected, we dropped it. In the spring 2008 edition of the Harvard Health Policy Review, I advanced far better alternatives to the individual mandate to expand coverage, relying on positive tax incentives and other mechanisms to facilitate enrollment in private health insurance. This is what researchers and fact-based policymakers do when they discover new facts or conduct deeper analysis.
Good for Moffit. The mandate was never a good or constitutional idea, and reflected a puzzling fixation on unpaid hospital bills that has never made much sense given the tiny sliver of health care expenditures those bills represent. Heritage’s endorsement of the idea long ago was both a policy error on its part and a political problem for conservatives fighting unwarranted federal intrusion. Good to see that someone is finally putting the band back together.