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Even so, at least some conservative Republicans likely will argue that Obama is stepping on individual rights by mandating coverage, expanding government's hand in the health care industry and creating a pathway to socialized medicine. Just last week, congressional conservatives offered their own plan. It would not mandate people to carry insurance. But even Republicans say a requirement is likely. "I believe there is a bipartisan consensus to have individual mandates," says Iowa Sen. Chuck Grassley, the top Republican on the Senate Finance Committee. The reason is fairness, he says: "Everybody has some health insurance costs, and if you aren't insured, there's no free lunch. Somebody else is paying for it." It's support like this that's meant Obama has been able to shift positions with seemingly little political peril. "Because there's a consensus among both the stakeholders and the legislators that this is the direction to go, the president essentially doesn't have a reason not to support it," said Judy Feder, a senior health care official under Clinton who now is at the liberal Center for American Progress. Still, Congress must figure out how to enforce such a mandate, eligibility for a so-called hardship waiver, tax credits so people can afford health care and subsidies for the poor to help them buy coverage.
House and Senate committees are in the midst of haggling over such issues, and independent analysts expect a final bill to emerge that includes both waivers and sliding-scale subsidies to meet Obama's conditions "There's no doubt that to be acceptable, it has to be regarded as fair and that you're not requiring people to buy insurance that's not affordable to them," said John Holahan, the Urban Institute's health policy center director. Any plan is likely to be modeled after one in Massachusetts, which required that virtually everyone have health insurance or face tax penalties. People who were deemed able to afford health insurance but who refused to buy it during 2007 faced losing a personal tax exemption and the prospect of monthly fines. The law exempted anyone who made less than the federal poverty level and gave them free care. And, those making up to three times the poverty level could get subsidize plans. Businesses with 11 or more full-time employees who refused to offer insurance also faced fines.
[Associated
Press;
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