"It will cover everybody. And I don't see how you cover everybody without an individual mandate." That's a senior administration official talking about Obama's vision for health care reform, as quoted by Ezra Klein over at his blog. And it's an important statement to get into print.
During the campaign for the Democratic presidential nomination, as you may recall, the only key difference between Obama and then-rival Hillary Clinton was whether government should require people to obtain health insurance--that is, whether to have an individual mandate. Echoing the conventional wisdom among health policy experts, Clinton argued that about a third to a half of the uninsured would remain without coverage if enrollment were purely voluntary. Obama, who had opted not to include a mandate for adults in his campaign proposal, said Clinton's plan could end up forcing people to buy coverage they couldn't afford.
But Obama's rhetoric was, at least in part, a product of campaign necessity: He was getting pummeled over the issue. And Obama parsed his words carefully, never quite ruling out the possibility of a mandate. When pressed, he typically acknolwedged that an indivdiual mandate might eventually prove necessary. He just didn't want to call for one at the outset, at least until he was certain good insurance had been made affordable.
That is still pretty much the official position. As reported here previously, the budget proposal Obama submits on Thursday will allocate a "significant" sum of money towards health care coverage. It will then call upon Congress to find (with Obama's help) more funding, in order to achieve universal coverage in a fiscally responsible way. The budget overview will say not a word about mandates--or, for that matter, many other programmatic details of health reform. This is all about the money right now. But, as Ezra's reporting makes clear, the administration is signalling that if Congress adds the mandate when it writes a bill, Obama won't raise bloody hell.Jonathan Cohn