Should we surgically repeal the individual mandate? YES

In a blog post today, Avik Roy reports that in the debt ceiling hike discussions, President Obama is willing to entertain a request by House Speaker John Boehner to repeal the individual health care mandate.

Mr. Roy argues that this would be politically “disastrous” for Republicans, because it would cause a death spiral in the private health insurance market, thus jeopardizing our efforts to repeal the President’s health care law, and could also jeopardize the effort to overturn ObamaCare in the courts.

While I usually agree with Mr. Roy, on this one I don’t agree.

1) Repealing the individual mandate would not cause an insurance death spiral in the private market — at least not at first. The mandate doesn’t even take effect until 2014. But repealing the mandate now would force Congress to move quickly to reopen the larger ObamaCare law, which would be a very good thing, both strategically and politically. I frankly just don’t see the political fallout for Republicans from eliminating a highly unpopular mandate more than 2 years before it even takes effect.

2) The odds of the current Supreme Court overturning the mandate seem rather low, despite the excellent legal case against the mandate’s constitutionality. I fear that letting the lawsuits dictate our legislative approach would be hanging more weight on the judicial peg than it can bear.

3) I agree with Mr. Roy, however, that congressional Republicans have been negligent in not moving ahead with legislation to replace ObamaCare with a patient-centered system. The public needs to know what the opponents of the government takeover of health care would replace that takeover with.

4) I think that the individual mandate is THE essential element in the whole ObamaCare scheme. (Exchanges are also important, but without a mandate, they won’t work.) If we can repeal the mandate now, legislatively, we should do it, period. The only place we have a chance of doing it is on a politically “must pass” bill like the current debt ceiling increase.

According to the Congressional Budget Office (CBO), repealing the mandate (by itself) would save taxpayers at least $250 billion over 10 years. It would, as I’ve said, make full repeal more not less likely. And of course it would strike a huge blow for individual liberty.

If it’s true Speaker Boehner put repeal on the debt talks table, kudos to him. But I find it very hard to believe President Obama would ever agree to eliminate it. (See point 4.) Alas, we may be discussing something here that isn’t even a real possibility.

Dean Clancy is FreedomWorks’ Legislative Counsel and Vice President, Health Care Policy