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Democrats: Law is Unworkable Without the Mandate

June 26, 2012
Below is a list of statements from key Democrats arguing time and again that, without the unconstitutional individual mandate, the Democrats’ health care law doesn’t work.

President Barack Obama

“Unless everybody does their part, many of the insurance reforms we seek — especially requiring insurance companies to cover pre-existing conditions — just can’t be achieved.”
Remarks made to a Joint Session of Congress on Health Care

“Well, it turns out that if you don’t — if you don’t make sure that everybody has health insurance, then you can’t eliminate insurance companies — you can’t stop insurance companies from discriminating against people because of preexisting conditions. Well, if you’re going to give everybody health insurance, you’ve got to make sure it’s affordable.  So it turns out that a lot of these things are interconnected.”
Interview with George Stephanopoulos, ABC News

Nancy Pelosi, D-CA, then-Speaker of the House

“In fact, it is the requirement for all who can afford insurance to have it that makes the math work…”
Press Release, “Health Insurance Reform Mythbuster”

“You have to have the mandate for [health reform] to work from a financial standpoint…”
Press Conference

Harry Reid, D-NV, Senate Majority Leader

“Congress determined after exhaustive hearings that without this financial incentive for individuals to maintain adequate coverage, it would not be financially practicable to prohibit insurance companies from denying coverage to those with preexisting conditions or otherwise to regulate effectively the national markets in health insurance and health care.  …The effective functioning of that major commercial activity is critical to the national health care market in which virtually every American participates.  …[ObamaCare] also requires individuals, with certain specified exceptions, to maintain minimum levels of health insurance coverage.  Second, in the Act, Congress expressly found that the [individual mandate] ‘is an essential part of this larger regulation of economic activity,’ the absence of which ‘would undercut Federal regulation of the health insurance market.’  Congress found that the [individual mandate] is ‘essential’ for a simple reason: otherwise, the new regulations would encourage individuals to delay or forgo insurance, knowing that they could not be excluded later for pre-existing conditions.  That would cause higher insurance prices and greater cost-shifting.  …Without the [individual mandate], the objective of the Act’s regulation of interstate commerce would be far more difficult, if not impossible, to attain.”
Amicus Brief to the Supreme Court co-signed by Minority Leader Nancy Pelosi

The Obama Administration

“Without an individual responsibility provision, controlling costs and ending discrimination against people with preexisting conditions doesn’t work.”
Op-ed by Attorney General Eric Holder and HHS Secretary Kathleen Sebelius
“…we have to have a requirement that everybody get in the system…”
Nancy-Ann DeParle, then-White House Director of the Office of Health Reform
and current White House Deputy Chief of Staff, Interview with Jeffrey Brown, PBS News

“It [the individual mandate] is key to the viability of the Act’s provisions that bar insurers from denying coverage or setting premiums based on medical condition or history.  …The experience of state insurance regulators demonstrated that this system of guaranteed issue and community rating would be unworkable without a minimum coverage provision that prevents health care consumers from delaying their purchase of insurance until their medical costs outstrip their premiums.  Learning from state regulators, Congress understood that these guaranteed-issue and community-rating requirements would be unsustainable if participants in the health care market could postpone purchasing insurance until an acute need arose.  Congress accordingly concluded that the absence of a minimum coverage requirement ‘would leave a gaping hole’ in that regulatory scheme.”
Brief in the 11th Circuit Court of Appeals case Florida v HHS

“The minimum coverage provision plays a critical role in that comprehensive regulatory scheme by regulating how health care consumption is financed.  In particular, the minimum coverage provision is key to the viability of the Act’s guaranteed issue and community-rating provisions.”
Supreme Court Brief on the Constitutionality of the Individual Mandate

Max Baucus, D-MT, Chairman of the Senate Finance Committee

“…it will be each individual’s responsibility to have coverage. This step is necessary to make the entire health care system function properly.  Requiring all Americans to have health coverage would also ensure that the insurance market functions effectively.”
Senate Finance White Paper “Call to Action: Health Reform 2009” 

“This is an amendment [to repeal the individual mandate penalty] that guts, kills health reform.”
Markup of Health Care Overhaul Legislation, Part 7: Senate Finance Committee, 111th Cong. 2009

John Larson, D-CT, Chairman of the House Democratic Caucus

“The mandate, if it’s struck down, pretty much guts the bill.”
Roll Call Article “Democrats Wary on Court Health Care Ruling”

Senator Tom Harkin, D-IA, Chairman of the Senate Health, Education,
Labor, and Pensions Committee

“The mandate is so central in terms of premiums . . . we would have to go back to the drawing board…”
CQ Article “Harkin Prepares Options in Case Court Rejects Health Insurance Mandate”

Congressional Democrats’ Legislative Findings

“In the absence of the requirement, some individuals would make an economic and financial decision to forego health insurance coverage and attempt to self-insure, which increases financial risks to households and medical providers … The requirement is essential to creating effective health insurance markets in which improved health insurance products that are guaranteed issue and do not exclude coverage of pre-existing conditions can be sold … The requirement is essential to creating effective health insurance markets that do not require underwriting and eliminate its associated administrative costs.”
Section 1501(a)(2)(H) of the Democrats’ health care law

Jonathan Gruber, Paid Obama Administration Consultant

“This new requirement to purchase insurance is clearly a major innovation in U.S. public policy.  But it is also a central pillar of health reform.  Without the individual mandate, the entire structure of reform would fail. This is not an idle conjecture.”
Center for American Progress report, “Why We Need the Individual Mandate”