Grassley Develops New Opposition To Individual Mandate, Proposes Re-Insurance Scheme

Sen. Max Baucus’s health care mark appeases top-line Republican concerns. Under the mark, undocumented immigrants are ineligible for coverage, federal funds cannot be used for abortion and the public option is no more (the list goes on here). But many Republicans are still raising the same stale objections; some are even inventing new reasons to oppose the legislation.

Yesterday, Sen. Chuck Grassley (R-IA) reiterated his concern about undocumented workers being eligible for coverage and public dollars being spent on abortions. Grassley has also developed a new-found opposition to the individual mandate — a policy that even health insurers support:

HEMMER: Now as I understand it, you want stronger language preventing federal funds from going to abortion. You want stronger language to make sure illegal immigrants are not covered. If you got those two big points, would you go for it?

GRASSLEY: No, there are other points as well, but let me mention other points that you didn’t mention. And one would be the individual mandate, which for the first time would have a federal penalty against people who don’t have health insurance. I could do that through re-insurance and risk pools, to make sure we get more people insured in a voluntary way and I’m very reluctant to go along with an individual mandate.

Watch it:

But just last month, when asked “how does this bipartisan group that you`re a member of get to more health insurance coverage if you don`t mandate that employers provide coverage,” Grassley replied “through an individual mandate and that`s individual responsibility and even Republicans believe in individual responsibility.”

During a June appearance on Fox News Sunday, Grassley said, “there isn’t anything wrong with it [an individual mandate], except some people look at it as an infringement upon individual freedom”:

But when it comes to states requiring it for automobile insurance, the principle then ought to lie the same way for health insurance. Because everybody has some health insurance costs, and if you aren’t insured, there’s no free lunch. Somebody else is paying for it….I believe that there is a bipartisan consensus to have individual mandates.

During yesterday’s interview however, Grassley found fault in the “automobile insurance” analogy, explaining to host Bill Hemmer that “owning a car and driving a car are voluntary, you don’t have to do it…in this particular case every American would have to have insurance or you would have a penalty,” he said.

Hypocrisy aside, Grassley’s ‘reinsurance scheme,’ along with his abortion and immigration objections, are simply wrong headed. Grassley would replace the individual mandate with reinsurance. To make-up for the cost of individuals who would only buy coverage once they become sick (and remember, under insurance reform, insurers would have to accept all applicants, regardless of pre-existing conditions), Grassley would allow insurers to pay into a “reinsurance fund” that would finance very high medical expenses. This way, he would protect the entire insurance pool from picking up the costs of individuals who purchase coverage after a crippling diagnosis.

This makes sense in the short term, but on the whole it’s bad policy. We spend about 75% of our health care dollars managing chronic diseases and comparatively little on preventing individuals from developing those diseases in the first place. Grassley’s initiative, in other words, would not do anything to catch folks on the front end of the illness, (like the mandate would) and fail to lower costs over the long term.

The abortion piece is no less peculiar. The Baucus mark preserves current policy by preventing federal money from funding so-called ‘elective abortions’ — abortions in cases of incest, life, or rape would still be covered. The mark forbids women from using subsidy dollars for abortion services and forces them to finance the procedure with private money. But Grassley is suggesting, like Tony Perkins does here, that a woman who wants to buy a benefits package that includes abortion services, should not receive any federal assistance– even if she’s using those dollars for unrelated services. In other words, women who purchase comprehensive packages — that include abortion services — must pay for the entire cost of the package (even if they qualify for subsidies).