February 03, 2008
CLINTON CONSISTENTLY REFUSES TO ANSWER THE QUESTION OF HOW HER MANDATE WOULD BE ENFORCED
FEBRUARY 3, 2008: Clinton Says People Who Don't Sign Up For Health Insurance "Won't Have to Pay Fines"; Then Says One Option For Enforcement is "Going After People's Wages." When asked about her enforcement mechanism, Clinton said, "Well, they don't have to pay fines, George. We want them to have insurance. We want it to be affordable." When pushed again on whether or not she would garnish wages, Clinton said, "George, we will have an enforcement mechanism, whether it's that or it's or it's some other mechanism through the tax system or automatic enrollments…And the reason why I think there are a number of mechanisms, going after people's wages, automatic enrollment, when you are at the place of employment, you will be automatically enrolled, whatever the mechanism is." (ABC, 2/3/08)
DECEMBER 1, 2007: Clinton Said She Would "Look At" Withholding Part Of Their Salaries To Pay For It. On a conference call with reporters to discuss the ad, Clinton policy chief Neera Tanden said the senator would "look at" working with employers to "automatically enroll employees, going through and withholding part of their salaries to pay for it - those are reasonable steps to enforce a mandate." When Clinton rolled out her plan earlier this year, Tanden hinted that the mandate might be enforced by threatening to deny tax deductions to people who refused to enroll for insurance. (DMR, 12/1/07)
NOVEMBER 28, 2007: Clinton Surrogate Frank Pallone Said That Clinton Would Have Penalties For People Who Didn't Enroll in Health Insurance. When asked how Clinton's plan would be enforced, he said "You can have automatic enrollment so that when you go to school or you go to the hospital, you are automatically enrolled. We will put in place mechanisms to make sure everyone is enrolled. Then we'd have enforcement mechanisms. There may be some penalty for those who are not enrolled. So it's not that hard to do...There are ways to enforce it and some of the states, you know, like Massachusetts that has it and others, do have some ways of imposing penalties in order to make sure." (MSNBC, 11/28/07)
SEPTEMBER 18, 2007: Clinton Said That They Didn't Have Any Punitive Measures To Enforce The Mandate Of Her Health Care Plan But Probably Would. Hillary Clinton said about the mandate in her health care plan, "At this point, we don't have anything punitive that we have proposed. We're providing incentives and tax credits which we think will be very attractive to the vast majority of Americans." (AP, 9/18/07)
EXPERTS SAY MANDATES NEED "HARSH SANCTIONS" IN ORDER TO BE EFFECTIVE
Letter From Health Care Experts: Mandates Without Harsh Sanctions Won't Result In Coverage. "Regardless of our feelings on this issue, what is clear from the evidence is that mandates alone, without strong incentives to comply and harsh punishments for violation, will have little impact on the number of uninsured Americans.1 Indeed, as the Massachusetts experience illustrates, non-compliance with mandates is a large problem, absent harsh sanctions. There is simply no factual basis for the assertion that an individual mandate, by itself, would result in coverage for 15 million more Americans than would robust efforts to make health care more affordable and accessible." (Letter from Health Care Experts, 1/31/08)
CLINTON STILL HASN'T ANSWERED WHAT KIND OF PENALTIES SHE WOULD HAVE UNDER HER PLAN – BUT OPTIONS INCLUDE:
Under the Health Security Act, Failure to Register With a Health Alliance And Pay Premiums Resulted in Fines of At Least $5,000 or As Much As Three Times Amount Owed. Under President Clinton's Health Security Act, "All American citizens not specifically exempted will be required to register with a health alliance. Individuals, families or employers must pay their required premiums. Failure to pay can result in a fine of $ 5,000 or three times the amount owed, whichever is greater. Health alliances will have government help in collecting from deadbeat subscribers: 'Each state shall assure that the amounts owed to regional alliances in the state are collected and paid to such alliances.'" (Times Union, 1/2/94)
Senator Chafee's Bill 1993 Included A New Tax For People Who Failed To Enroll in Health Insurance. Senator Chafee's 1993 bill, S. 1770, imposed an individual mandate for health insurance coverage that applied to all U.S. citizens and legal permanent residents except those opposed to health plan coverage for religious reasons. Those who failed to comply with the mandate would be subject to a tax equal to 120 percent of the average premium cost for the "lower priced ½" of standard health insurance packages. The IRS, together with HHS, was responsible for enforcing the mandate. (CBO, August 1994; S.1770, introduced 11/22/93, section 1501, section 5000A, section 91(b)(2); National Tax Journal, 9/1994)
Senator George Mitchell's 1994 Health Care Plan Contained A Fine Of Up To $10K Per Worker On Employers Who Fail To Offer A Health Care Plan; Senate Voted 100 To 0 To Drop The Provision. "Majority Leader George J. Mitchell (D-Maine) and Minority Leader Robert J. Dole (R-Kan.) were conciliatory but noncommittal after back-to-back appearances before the group. Members said both leaders encouraged their efforts and plan to meet with them again today after their final proposal is ready. The surprise meeting came as the Senate slogged through its second day of voting on Mitchell's scaled-back version of health reform legislation originally proposed by President Clinton. With Democrats ceding a victory to Republicans, the Senate voted, 100 to 0, to drop proposed fines of up to $10,000 a worker on employers who fail to offer a health plan providing a standard set of medical benefits. … They argued that the $ 10,000 penalties exemplified the 'heavy hand of government' present throughout the 1,443-page Mitchell bill. The Mitchell plan attempts to use subsidies and insurance reform measures to increase insurance coverage to 95 percent of the population by the year 2000. If coverage falls short, employers might be required to pay 80 percent of the cost of their workers' insurance." (Washington Post, 8/18/94)
Range Of Options For Enforcing Individual Mandate Are Unpopular. "Enforcement of an individual mandate could vary from requiring documentation of coverage on tax forms, as the Chafee plan proposes; facing a fine equaling 120% of a typical premium; or revoking personal income tax exemptions for those who don't buy insurance, as the Nickles-Stearns bill suggests. "But many observers think that tough IRS enforcement would be politically unacceptable and logistically difficult." Nelson: "You could nail people by doubling their income tax, but what difference does it make if they have no assets?" Furthermore, "most uninsured people wouldn't be found out until after they became ill," which ACP's Dr. Paul Griner calls "a nightmare." (American Health Line, 1/21/94)
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