A Mandate By Any Other Name

Newt Gingrich

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Newt Gingrich opened a can of worms when he was asked about the Republican plan passed by the House which radically changed Medicare. Gingrich called it “right-wing social engineering.” More importantly his comments brought to my mind and to others the uncomfortable contrast between the Republican plan and what they have been saying about the Affordable Care Act (ACA).

Republicans have been egging on the states to sue the government claiming that Health Care Reform (ACA) is unconstitutional because it mandates people to buy health insurance.

There’s the rub. The Republican plan does the very same thing, except in a bigger fashion. The Republican plan takes money that would fund your healthcare and uses it to subsidize your private health insurance premiums.  In other words, the only way you’re getting any of that money that you’ve spent your life paying into Medicare is for you to buy health insurance. Government financial rewards for buyers of insurance is precisely what the Republican plan offers, and it is precisely what they’d like to claim is unconstitutional about the Democrat’s plan.

Now, I have read some conservative commentators who write that this comparison is not fair. (see: National Review) However, on page 46 of Paul Ryan‘s “Path To Prosperity” it states, “This is not a voucher program, but rather a premium-support model. A Medicare premium-support payment would be paid, by Medicare, to the plan chosen by the beneficiary, subsidizing its cost” (italics mine). I don’t get it. Is there a difference between a voucher and a deal that pays premium-support money to a service provider rather than directly to you?

What I do get is that words matter. In politics, it isn’t as important what you are saying as how you say it. But it is the job of the electorate to see behind the curtain and to call out politicians who are trying to use words to mislead. To me Ryan’s plan calls for replacing Medicare healthcare with a voucher to buy insurance from a private insurer. And if his plan is taking money that currently is designated to fund my healthcare and directs it in a way so that I cannot receive its benefit unless I buy insurance, then that sounds to me like a mandate to buy health insurance.

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