One of the six ways the Supreme Court could rule on Obamacare is to strike down its individual mandate while keeping the rest of the health care overhaul intact. Politico reports that liberal legislators, anticipating this prospect, are looking for alternatives to the federal mandate, especially to “state-based individual mandates — like the one in Massachusetts.”

If the Court strikes down only the individual mandate, Obamacare would become even more unworkable than it is already. With younger and healthier people no longer forced to buy government-approved health insurance at government-mandated inflated rates (so as to force them to subsidize the insurance of others), prices for everyone else in the market would skyrocket — in response to Obamacare’s additional mandate that insurers cover people with expensive preexisting conditions without charging them higher rates. In short, without the individual mandate, the whole house of cards would topple, leaving only two choices: repeal, or replacing the mandate in some way.

Brainstorming ways to bring about the latter result while avoiding the former, Politico writes that liberal state legislators are looking to Massachusetts:

“A group of progressive state lawmakers from across the country is considering what can be done to encourage residents to buy insurance if the federal health reform law’s individual mandate is struck down by the Supreme Court….

“Those measures could range from state-based individual mandates — like the one in Massachusetts — to incentives for people to buy insurance on their own….

“‘There’s nothing that precludes the states from passing an individual requirement,’ said [Mila] Kofman, a former Maine insurance commissioner. ‘That would be the best way to ensure that people participate and buy health insurance not only when they’re sick.’

“States could also look for additional incentives to join the pools, such as more tax credits for low- or middle-income consumers, Kofman said. But many states may be too financially strapped to consider that option.

“As former Massachusetts Gov. Mitt Romney has defended the Bay State’s plan in the presidential primary, he has stressed that it is perfectly acceptable for states — as the laboratories of democracy — to enact mandates.”

Politico notes that such mandates have been banned in many strongly Republican-leaning states, including Alabama, Georgia, Indiana, Kansas, Montana, North Dakota, Oklahoma, Tennessee and Wyoming, as well as in several important swing states like Florida, New Hampshire, and Virginia. Politico writes that Virginia “passed its legislation shortly before the federal health care reform law was enacted in March 2010,” and that legislation “is the basis for the state’s legal challenge” to Obamacare.

Politico adds, “[Washington state Sen. Karen] Keiser said she would expect some states to consider the ‘Saskatchewan option,’ a reference to Canada’s universal health system, named after the first providence to implement it.” In other words, they would consider implementing full-fledged socialized medicine. As Yuval Levin has observed, if Obamacare isn’t repealed, the entire United States of America will likely head down this same path, as Obamacare was “designed to push people into a system that will not exist”— it was designed to be “a health care bridge to nowhere.”

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