I'm largely indifferent to the debates on the constitutionality of individual mandates. My expectation is that the issue would end up before the SCOTUS. Once it got there, Scalia, Roberts, Thomas, and Alito would likely find it to be unconstitutional, while Breyer, Ginsberg, Sotomayor, and Stevens or his replacement would hold to the contrary. Kennedy would be the likely swing vote, and none of us really have a clue as to how he might decide under such circumstances.
What I'm not indifferent to is the politics of this proposal. The big question I've yet to see any supporter of the Senate bill address is how the mandates will be enforced. I'd forgotten how contentious this issue was during the 2008 primaries.
Most of us still recall HRC's famous "Shame on You, Barack Obama" soundbite. I'd forgotten what drew her ire was the Obama campaign's characterization of her position on individual mandates. At the time, candidate Obama's position was summarized as follows:
The concept of an "individual mandate" became a lightning rod between the two yesterday. Obama said at an Ohio hospital that Clinton would "have the government force you to buy health insurance, and she said that she'd consider 'going after your wages' if you don't," while Clinton criticized her rival for "perpetuating falsehoods" and labeled an Obama mailing on the issue as "right out of Karl Rove's playbook."
Candidate Obama was probably correct on this point. Garnishing wages would be the easiest means of enforcing the individual mandate. There will inevitably be people w/ leviable assets (including, perhaps, KO) who refuse to buy insurance as a matter of principle. I suspect, however, that most of those who are subject to penalty will lack readily collectible assets. Garnishment will likely be the most practical means of enforcement.
Putting aside those w/ means who refuse to buy insurance, garnishing the wages of people who are struggling will be politically suicidal. Do we really want to see Uncle Sam acting as a heavy-handed collection agent for Humana/Wellpoint/BCBS? Do we want to see Sam doing so when he hasn't provided a PO or some other means of effective competition for the carriers?
To make matters worse, when garnishments start, the public will identify them w/ 1 party. The GOP, virtually to a member, has opposed this bill from start to finish. They have shown a discipline in opposition that was largely unthinkable for the Dems from 2001-06. They will inevitably reap the benefits from the political firestorm that will likely ensue.
This change in position on mandates is, of course, accompanied by a change in position on excise taxes on health insurance. The Obama campaign viewed the issue seriously enough to run an ad blasting McCain for proposing such a tax. Since the excise tax would impact upon union-negotiated plans, it is bitterly opposed by labor.
Garnishing wages to enforce mandates when you blasted your primary opponent about them is politically dangerous. Simultanaeously imposing excise taxes upon union members' health care plans when you blasted your GE opponent on them multiplies the danger. Doing so w/o having even a fig leaf of "bipartisanship" to provide you w/ political cover in 2012 borders on political suicide.
Supporters of the Senate bill tend to portray themselves as the "realists" in this debate. By doing so, they apparently ignore the political realities posed by the feds garnishing wages on behalf of Humana. They further ignore the realities posed by taxing hard-won union benefits. Worst of all, they ignore the reality that the GOP will run ads replaying clips from 2008 that show Obama's changes in position on these issues.
Some of us apparently have differing views of political reality.
UPDATE: The transcript of a CNN debate contains the following statement of position by Sen. Obama:
So we've got a lot of similarities in our plan. We've got a philosophical difference, which we've debated repeatedly, and that is that Senator Clinton believes the only way to achieve universal health care is to force everybody to purchase it.
And my belief is, the reason that people don't have it is not because they don't want it but because they can't afford it.
This soundbite will almost inevitably be GOP fodder in 2012.