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The Public's Inch-Deep Hate Affair With the Individual Mandate The Public's Inch-Deep Hate Affair With the Individual Mandate

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The Public's Inch-Deep Hate Affair With the Individual Mandate


Yasemin Ayarci, of Levittown, Pa., holds a sign as she is shouted at by the opposition during demonstrations outside the Supreme Court on the second day of deliberations over the Affordable Care Act.  (Chet Susslin)

Maybe the individual mandate is doomed, as an agitated-slash-celebratory Twitterverse seemed convinced after conservative Supreme Court justices posed challenging questions about it (shocking!) on the second day of arguments on the Affordable Care Act. If the justices vote later this year to kill it, with the possibility that the whole law will collapse as a result, Republicans would be vindicated in their fight against "big government." But in practical terms, would the country really know what it has lost?

From a political standpoint, the mandate invented by the GOP of yore ("yore" being a dozen years ago) has been manna for today's GOP. Polling shows the requirement to buy insurance or pay a fine -- meant to discourage freeloaders -- has become highly unpopular. Strangely, the dreaded mandate is not particularly unpopular in Massachusetts, the only state that charges penalties for not buying coverage.

Disapproval of the individual mandate nationally, meanwhile, seems to be a mile wide but not all that deep. There's evidence that many people don't understand what it is, why it is, and how it would affect them, and that their answers change depending on word choice and word sequence.

They like it better - about even with disapprovers in a Pew poll -- if the last thing they hear is about subsidies to help lower-income people buy insurance. They like it somewhat when it's explained that without it, people would just buy insurance when they got sick (driving up costs for everyone) or alternatively, insurance companies could not be required to cover people with existing medical problems (because without a mandate, there wouldn't be enough healthy people in the pool). They like it best - 61 percent approval in a Kaiser Family Foundation poll -- when they're told it won't apply to most people because they have insurance through work.

That spike to 61 percent, nearly twice as high as the 33 percent who support the mandate when asked a simple up-or-down question, is telling. It suggests many Americans aren't comrades-in-arms with conservatives waging an ideological battle - they're just people nervous about change and relieved to hear it won't affect them.

Attitudes toward the overall health law are just as complicated as those toward the mandate. A new CNN/ORC International poll, like most polls, finds that the law is unpopular - favored by 43 percent, opposed by 50 percent. Breaking down the numbers further, CNN found 43 percent favor it, 37 percent oppose the law because it's too liberal, and 10 percent oppose it because it's not liberal enough. Hello public option!

You have to wonder if that 10 percent - which has gone as high as 14 percent in earlier CNN polls - keeps doggedly voicing opposition to the law in hopes the Supreme Court will strike it down and force Congress to regroup. At some point, as 50 million uninsured rises to 60 million and 70 million and higher, as more states approach the astonishing Texas rate of 26 percent uninsured, Congress may decide it has to do something. And, barred from effectively regulating the private market, there will be no options except the public option - Medicare for all.

That should be a safe course. After all, the policy already exists. But in the current climate it's not hard to envision a conservative challenge to Medicare, and who knows what the Supreme Court might do?

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