John R. Graham argues in the comments that the mandate wonโt 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 itโs not problematic to eliminate the mandate now, because it doesnโt go into effect until 2014. Mario Loyola argues that โenlargingโ the Obamacare problem is a good thing. Reihan Salam thinks Iโm 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 itโs simply not good business practice to introduce the risk that the private insurance market could go completely away if the GOP doesnโt 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 โwhose problemโ 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 itโs not merely about winners and losers in Washington. I donโt think heโs right that Republicans would avoid blame for a provision that they actively negotiated for.
And Iโm of course glad to be on the same side as Reihan, my blogging mentor.






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