Sen Charles Grassley (R-Iowa) originally
supported individual mandates but now
opposes it
Before a bill is even close to passing, the specter of a constitutional challenge to individual mandates threatens to derail any health care reform.
Understanding individual mandates
If individual mandates are found to be unconstitutional, the bills from every single committee will certainly collapse.
See a comparison of the 3 major bills now pending
Two states, currently have imposed individual mandates on their residents, Massachusetts and Hawaii.
See how the Massachusetts plan is working
The constitutional challenge is mostly shepherded by conservatives and libertarians. They do not believe that the federal government has the right, power or authority to compel everyone to buy health insurance.
The federal government has specifically mandated only three things in the history of this country:
Federal income tax
The military draft
The requirement that all wage earners contribute to social security
Legal scholars on both sides of the issue point to the commerce clause of the Constitution to support their views. The Congressional Budget Office (CBO) during the debate over the Clinton health care plan in 1994 called an individual mandate “an unprecedented form of federal action.”
States will want to control the health insurance options for their residents
In Congress opposition to a mandate is growing. Sen. Charles E. Grassley (R-Iowa), who supported the idea earlier this year, now oppose it. Opponents of individual mandates argue that compelling people to spend part of their income on something they may not want is an unwarranted intrusion by government.
It is reasonably clear that to actually achieve the overhaul of the current health insurance system an individual mandate is essential. Without it there is no way to make health insurance affordable. Only by expanding the risk pool to include the young and the healthy, many of whom go without insurance now, would universal or near universal coverage be possible.
The insurance lobby will not support overhauling the system without the individual mandates.
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