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Thank-you.

The argument was that the individual mandate was absolutely necessary to prevent an adverse selection death spiral in the marketplace. That was what what policy wonks and economists were arguing at the time.

People always have a choice when a branch of their government chooses to behave in flagrantly illegitimate ways. And most of the time, people choose to let them keep doing it, Because It's Just Easier. But sometimes the people very suddenly choose otherwise.

Along these lines, the whole reason we have the Shadow Docket was that Roberts was afraid that Obama's clean energy targets would tank the economy. Reader, the market hit those clean energy targets regardless by virtue of improving battery tech.

Meaning it’s very plausible that without the deal they struck, there would have been 5 votes to strike down all of the major individual market reforms (if not the entire ACA) on severability grounds. That’s a much harder choice to make at the time.

What a weird AI bot

they don't have any policy staff!!!!!!!!

I’m not so sure about that. Premium increases over the past few years have been substantial and next year we’re in for the highest increase yet. That’s largely due to healthier people dropping coverage as premiums skyrocket. I have an ACA plan that went up 25% last year.

Also I expect letting people stay on their parent’s insurance until 26 probably filled in a lot of the gaps that a mandate would have addressed. That’s the specific cohort that’d be most likely to shrug it off.

Well, one presidential primary candidate thought so, before he didn’t.

well sure, but perhaps an indication of what type of thinking was dominant among policy thinkers who had the ear of Democratic officials from say 2007-2013 or so!

Since exchange subsidies are set at percent of income regardless of the actual premiums true death spiral was literally impossible. "Experts" were actively gaslighting everyone. Insane Obama team took a high risk strategy of arguing whole law should be thrown out if mandate was repealed.

That was the metaphor! And everyone used it. Krugman talked about it too. And in terms of direction of effect everyone was correct. It's the magnitudes that matter and that turned to be quite smol relative to other pushes/pulls.

This was basically known from when I was on the hill in ~2010 from people at CBO. Maybe the generalists but the healthcare folks knew it was a paper tiger once it was passed and the only real value was the initial nudge.

And back to the legal side what was wild was that no lower court came anywhere close to declaring the Medicaid expansion unconstitutional! Roberts just made a thing out of it to logroll with Breyer and Kagan, and turned out that was a wayyyyy more significant policy change than ending the mandate!

I would start with kids, but either way you would need to pass a bill at some point

Yeah, it turned out adverse selection was blocked by the fact that the American medical payment system relies so much on overbilling and hoping the patient pays that a young healthy American still needs insurance as protection from overbilling.

Which was the intended act of sabotage to begin with. Instructive for people who think Republican health policy is a product of ignorance

that’s what you took from this it’s no wonder were so fucked

it sure underlines how the whole decision had nothing whatsoever to do with the constitution or any legal principle, it was 100 percent grubby political horse trading

In addition, zeroing out the mandate penalty did cause average premiums to spike by an extra 6%, which means unsubsidized enrollees have been paying an additional $580/year apiece every year since 2019. www.nytimes.com/2018/12/27/o...

That's not a guarantee if there's no push over the first hurdle. Then there's inertia, which only happens later.

You may remember that during the 2008 primaries Clinton and Obama sparred over healthcare policy and Clinton critiqued Obama's proposal because it did not include an individual mandate. I remember thinking Obama seemed a bit green on policy.

No, it is too early to declare victory here.

To work, no, but the point on the curve and the slope matters-a real toothful mandate would nudge more healthy people into the system and make premiums cheaper.

but it would have worked better with mandate. still without it, it's better than without the whole package

I think it depends on the definition of "work". people with higher risk profile can buy insurance that won't break the bank, and enough people with lower risk profile will buy it that the pricing sort of works. But we didn't get the percentage of uninsured to 99% or 95%

The FED Govt issues the currency. Stephanie Kelton could have told them that the mandate wasn’t needed.

It's now $450/ month for a Bronze plan for one person The death spiral took a while but it's here

Wow, they probably shouldn't be in charge of writing or heavily modifying laws! Too bad about our terrible Constitution lol