Opinion: Healthcare reform vs. individual liberty, GOP edition

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Republican members of Congress have started spouting Reason magazine-style arguments against the individual mandate in the healthcare reform bills moving through the House and Senate. For example, Sen. John Kyl (R-Ariz.) called the mandate ‘a stunning assault on liberty,’ and Sen. Charles Grassley (R-Iowa) declared that ‘Individuals should maintain their freedom to chose health-care coverage, or not.’ Setting aside for a moment the support that Republican lawmakers expressed in the not-too-distant past for the individual mandate (including the Republican governor of a certain large West Coast state), it’s just ... unseemly for the GOP to stick a shiv in the ribs of the insurance companies they’ve been protecting throughout this debate.

Remember, the main proponents of the mandate are private insurers, who like it for at least two reasons. It brings a significant number of young, healthy people into the risk pool, which should improve their margins. And it helps solve the ‘adverse selection’ problem that would be caused if insurers were required to offer coverage to everyone, with no increase in price for those with pre-existing conditions. The insurance industry’s trade association has agreed to such regulations as part of a package of changes that includes an individual mandate.

The main argument these days against the mandate is that Congress doesn’t have the power to impose it. Slate’s Timothy Noah has explored this interesting constitutional question, concluding that it is, in fact, legal. It would be more of a slam dunk, IMHO, if Congress allowed insurers to offer policies across state lines, which the proposal from Senate Finance Committee Chairman Max Baucus (D-Mont.) would do under certain circumstances. Even without interstate policies, I think there’s a good case to be made that requiring people to carry health insurance is akin to requiring them to pay into the Social Security and Medicare trust funds -- it’s a forced contribution into a national system of shared risk and cost, albeit one administered largely by private entities.

Nevertheless, I’ll freely admit that there are compelling arguments on the other side too. It’s just strange to hear that position taken by the same Republican lawmakers who fight even the mildest version of a public-plan option on the grounds that it’s bad for private insurers.

Updated on Sept. 24 at 2:50 p.m.: I just came across a thorough discussion of the constitutional issues triggered last month by Jonathan Adler at the Volokh Conspiracy blog, with a follow-up last week by Adler. The posts are well worth reading, along with the comments, if you want to dive further into the weeds.

-- Jon Healey