Mandatory health insurance becomes an issue

The Sacramento BeeJanuary 11, 2010 

Michael Sertic, a college senior studying economics, is young and healthy, and he doesn't want the government forcing him to buy health insurance.

He is among a group of people on both the right and the left ends of the political spectrum who object to proposals in Congress that would compel nearly every American to buy health insurance or face a fine.

"I happen to believe it's unconstitutional. Government shouldn't be forcing someone to pay for someone else's health care," said Sertic, 24, a member of Students for Liberty, a club at California State University, Sacramento, that espouses libertarian values.

The so-called individual mandate, a centerpiece of the sweeping effort to overhaul the country's health care system, seemed a non-issue during most of the early debate just months ago, but in recent weeks it has emerged as another obstacle in the effort to pass legislation providing health insurance to millions of Americans who lack it.

Libertarians condemn compulsory health insurance as unconstitutional, while some liberals argue that it would further allow insurance companies to hold consumers hostage to ever-increasing premiums. That's particularly true, they say, if the final health care legislation does not contain a "public option," or government-run health insurance program, that could provide competition to private insurers.

Insurers, though, support the individual mandate. They say they already have made major concessions in the health care legislation, including a requirement that they issue coverage to anyone regardless of medical history. Mandatory insurance is necessary, they argue, to spread the burden of paying for health services that will surely result from having to cover the country's least healthy.

The individual mandate is just one component of the legislation, which also proposes payroll taxes on employers to help fund subsidies for uninsured people who cannot afford premiums on their own. Proposals in the House and Senate would not require people with extreme financial hardship to buy health insurance.

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