Editor’s note: Dana Milbank is taking one week off. His column will return next week. ADVERTISING Editor’s note: Dana Milbank is taking one week off. His column will return next week. It’s pretty clear that the implementation of Obamacare will
Editor’s note: Dana Milbank is taking one week off. His column will return next week.
It’s pretty clear that the implementation of Obamacare will set the tone for how Americans think about government for years to come. There are two large questions to be settled, which you might call the questions of competence and coercion.
The first is whether the government is competent enough to manage large programs. Can the administration get the website to work, set rules for the right insurance products or impose efficiency measures to restrain costs?
These are still open questions. Democrats see the early messiness as the temporary teething pains inevitable to a new large enterprise. Republicans see them as the first stages in the unraveling of an unworkable Rube Goldberg machine. But the fact is that we can’t yet know who is right. Over the next few years, the implementation will either go more smoothly and build faith in federal competence or go as it has been and destroy it.
But we’re already getting a clearer answer on the question of coercion. Cast aside for a second any negative connotation to that word. Almost all large government programs, even very popular ones like Social Security, involve a degree of coercion. Government builds a system and forces everyone to operate within it.
Obamacare, as originally envisioned, mandated that people join the system in order to redistribute money from the healthy and young to the sicker and older. It coerces some people to do something they might not want to do, and which, in fact, may not be in their short-term interest to do.
Already, it’s very clear that millions of Americans — and not just Tea Party types — do not accept the legitimacy of the government to overrule individual decisions, even on something like health insurance. This is not the America of 1932 or of 1964. This is an America steeped in distrust of government. It’s an America that is, on both left and right, steeped in the ethos of individual choice. It’s an America steeped in a morality of authenticity, which says that it is right to listen to the individual voice within and immoral to be forced to conform to the external commands from without.
From the very first moment, people have had problems with the idea of mandates. Barack Obama beat Hillary Clinton among a Democratic primary electorate in 2008 in part because he opposed mandates. When Obamacare was still a bill, members of Congress succumbed to political pressure and lowered the penalties that would be imposed on those who violated the mandates. Then the Supreme Court majority decided the penalties weren’t even penalties; they were just an optional tax.
When disgruntled groups have objected to the employer and other mandates during implementation, the administration has generally loosened, delayed or suspended them. Late last week, the administration granted a “hardship exemption” to people who had their prior coverage canceled and who believe that the mandated Obamacare offerings are unaffordable.
Most telling, the administration hasn’t even made a moral argument for the mandates. It hasn’t even tried to make the case that coercing some people to participate in collective action is necessary for the common good.
It now seems possible that no one will be paying the mandate penalties in 2014. Having exempted some groups from the mandate already, it will be politically difficult to start enforcing it on others. And, looking further into the future, why should we think Democrats will suddenly crack down and enforce the mandate in the run-up to the next presidential election?
This part of the law is like an unpopular, insecure person at a family reunion, who is walking on eggshells and making concessions right and left for fear of offending anybody. In the age of the Internet, people are used to decentralized systems and maximum personal choice. The mandated elements of Obamacare may look good on paper and they may be necessary to get the plan to work, but they probably can’t survive the public sense they are illegitimate.
Governing in an age of distrust is different than governing in an age of trust. Government now lacks the legitimacy to impose costs on losers, so politicians face unprecedented pressure to create situations in which everybody looks like winners. Government lacks the legitimacy to coerce. People like Social Security, but I bet you that Congress could not pass a Social Security law today. If people were unfamiliar with the concept, you couldn’t pass a bill that said: Government is going to confiscate money from each paycheck and spend it on other things, but don’t worry because you’ll get it back decades from now when you retire.
The erosion of the mandate won’t kill Obamacare overall. It’ll just make it much more expensive for the government. But the larger lesson is that to sustain a program in this culture, you probably have to rely on policy mechanisms that maximize consumer-style choice, not mandates.
