The Washington Post's Ezra Klein and the New Republic's Jonathan Chait, two men who believe as an article of faith that government-run health care is the irresistible wave of the future, claim that they aren't fazed by this week's federal district court ruling declaring Obamacare's (in the words of the New York Times) "keystone provision" unconstitutional. Both say that work-arounds could be designed to allow Obamacare to function without the mandate. But in addition to being problematic from a legal and policy perspective, any such efforts to save Obamacare would presumably require subsequent legislation, which almost certainly wouldn't pass. Moreover, Secretary of Health and Human Services Kathleen Sebelius and Attorney General Eric Holder disagree with Klein and Chait.
Immediately following the federal court ruling, Sebelius and Holder wrote in the Washington Post that a ruling declaring the individual mandate unconstitutional—should the ruling hold up on appeal—"would have devastating consequences." In their piece, they disingenuously refer to the mandate as a requirement that Americans buy "basic health coverage." In reality, it is a requirement that Americans buy federally approved health coverage, which—as the Congressional Budget Office (CBO) has noted in projecting that Americans' premiums would rise—would be anything but basic. Regardless, Sebelius and Holder maintain that, without the individual mandate, "Premiums would skyrocket" and "coverage would be unaffordable." Without the individual mandate, they conclude, "controlling costs and ending discrimination against people with preexisting conditions doesn't work."
In other words, Obamacare is fundamentally about coercion: Without forcing Americans, under penalty of law, to buy a product they don't want, it can't work.
Of course, with or without the individual mandate, Obamacare wouldn't work—which is why nearly two-thirds of Americans want to repeal it. In its real first decade, 2014 to 2023, Obamacare would cost over $2 trillion (according to the CBO); would funnel over $1 trillion from American taxpayers, through the federal government, to private insurers (according to the CBO); would raise Americans' taxes by hundreds of billions of dollars (according to the CBO); would siphon nearly $1 trillion out of Medicare and spend it on Obamacare (according to the CBO); would raise nationwide health costs by hundreds of billions of dollars in relation to projected costs without Obamacare (according to the Medicare chief actuary); would jeopardize the preexisting employer-based insurance of millions of Americans (according to a leaked Obama administration memo); and would make Kathleen Sebelius, an unelected officeholder, perhaps the second most-powerful person in the United States of America.
Still, Sebelius's and Holder's admission that, in their estimation, Obamacare can't function without the individual mandate, is telling.