Convergence on Health Care? If the Supreme Court knocks out Obamacare’s “mandate” for individuals to buy health insurance–and the penalty for not buying it–the dilemma for Obama, even if he’s reelected, is this: It might be relatively easy to come up with substitutes that would be constitutional–e.g., de facto taxes on those who don’t have insurance, for example, or extra charges on those who get ill and buy coverage late. But it will be hard to get such legislative fixes through a Republican House. What to do? Well, why not let the states supply the fixes?** Those states that want to make Obamacare work will pass their own taxes and have their plans approved by HHS. The states that don’t want to supply the fix won’t. The success of the former group of states will presumably shame the states that don’t try (and as a result experience some form of ‘death spiral,’ leaving many of their citizens uninsured.) It would provide an incentive for voters to elect Obamacare-friendly state officials. …
Why isn’t that a relatively good outcome? That it also dovetails with Mitt Romney’s federalist approach seems like a feature, not a bug. Maybe Obamacare ends up in the same place no matter who wins in November. …
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**–I make that argument in this Ricochet podcast.