The Politics of a Health Care Experiment

We've heard tons about the policy merits of Massachusetts' new health care plan, which, among other things, requires that all state residents obtain health insurance. ...
by | September 8, 2006

We've heard tons about the policy merits of Massachusetts' new health care plan, which, among other things, requires that all state residents obtain health insurance. What's largely been overlooked, however, is the political dynamics of this kind of individual mandate.

This angle deserves more attention because on its face the idea sounds like a tough sell. Poorer people in particular might not react kindly to being told that they now have no choice about purchasing health insurance.

The Massachusetts plan seems to avoid this pitfall with generous assistance to low-income residents, but if that fact doesn't get through to Bay Staters, or if other places try individual mandates without such generosity, it's not hard to imagine a backlash against the concept.

This possibility isn't merely theoretical; it may be playing out in Ohio right now. Republican gubernatorial nominee Ken Blackwell proposed an individual mandate late last month. Importantly, he didn't offer many details on how much financial assistance the state would offer to the poor.

Whether this proposal creates a political liability for Blackwell remains to be seen, but one person you who thinks it will is his Democratic opponent, Ted Strickland. He instantly pounced on Blackwell's plan, criticizing the idea in an e-mail that arrived in my inbox a couple of hours BEFORE I received an e-mail from Blackwell's camp announcing his proposal.

Strickland's message claimed Blackwell's individual mandate would cost Ohio residents as much as $7 billion over four years. Within a week, he had a T.V. ad (see "Tax Cuts") on air hammering this message home.

Josh Goodman
Josh Goodman  |  Former Staff Writer
mailbox@governing.com

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