Mandate's Value? Try $116 Billion

Amazingly, Republicans have managed to transform the mandate from an exemplar of personal responsibility into the biggest public policy bogeyman of all time.

The irony of the fight over the mandate is that President Obama was against it before he was for it. During the 2008 campaign, one of the signature differences between Obama and Hillary Clinton was that Clinton's health plan included an individual mandate whereas Obama's mandate covered only children.

Once elected, Obama quickly recognized the inescapable truth: An individual mandate was essential to make the plan work. Without that larger pool of premium-payers, there is no feasible way to require insurance companies to cover all applicants and charge the same amount, regardless of their heath status.

In part, hostility to the mandate reflects a broader uneasiness with perceived big government encroachment.

In the Kaiser poll, 30 percent of those who opposed the mandate cited government overreach as the biggest reason. Not surprisingly, twice as many Republicans (40 percent) cited that reason as did Democrats (18 percent).

But opposition to the mandate also stems from the public's failure to understand -- or, alternatively, the administration's failure to communicate -- basic facts.

For example, Kaiser found that when people were told that most Americans "would automatically satisfy the requirement because they already have coverage through their employers," favorability toward the mandate nearly doubled, to 61 percent.

Favorable attitudes rose to nearly half when people were told that without the mandate, insurance companies would still be allowed to deny coverage to those who are sick; that without the mandate people would wait until they were sick to purchase insurance, driving up premium costs; or that those unable to afford coverage are exempt.

"People don't understand how the mandate works at all and they don't understand why it's there," Kaiser's polling director, Mollyann Brodie, told me.

Brodie suspects that it's too late to change minds. "This law as a whole has really become a symbolic issue to people and they really aren't open to information," she said.

Maybe, but the administration must keep trying -- not only to sell the law's goodies but to explain how the mandate makes them possible. Otherwise, they could end up winning the minds of the justices, yet losing the hearts of the people whose votes they need to keep the law in place.