Obamacare shrugged

Until a year ago, Obamacare’s fans could continue to pretend the emperor wasn’t naked. Their scheme to control the behavior of their fellow citizens was all good intention.

But now, a year has passed since Congress repealed the individual mandate to purchase health insurance. And the elapsed time has revealed that Obamacare’s least popular element was not nearly as important to the law’s functioning as its proponents had represented.

This complicates the recent ruling in Texas. A federal judge there struck down Obamacare on the grounds that the law supposedly cannot survive without the now-repealed mandate and its financial penalty against the uninsured. Without such a mandate, the argument went, the young and healthy will fail to purchase insurance, leaving only the sick and old in an increasingly unsustainable and expensive insurance pool.

At the time of the Obamacare debate, the core function of the individual mandate was to please the insurers, whose lobbyists (and whose future lobbyists, working for Democratic members of Congress) were heavily involved in drafting the law. If they were going to be put on the hook for extra risk in the form of sicker and currently uninsured patients, they wanted a captive market in return. This was part of the framework that the insurance lobby unveiled two weeks after former President Barack Obama's election as their opening bid.

America's Health Insurance Plans, the umbrella lobby for the industry, proposed that "health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance."