A while back I wondered how Hillary Clinton would enforce her mandate that all Americans have health insurance. In today's Kaiser Daily Health Policy Report, my question is partially answered:

"Policy advisers for Clinton on Saturday said that she would consider a proposal to garnish the wages of some U.S. residents who can afford health insurance but do not obtain coverage, the Long Island Newsday reports. Under her health care proposal, Clinton would require all residents to obtain health insurance, with subsidized and no-cost coverage provided to those who qualify. Neera Tanden, a policy adviser for Clinton, in a conference call with reporters said that Clinton would consider a proposal to have employers 'automatically enroll employees' in health insurance and withhold 'parts of their salaries to pay for it.' According to Tanden, 'these are reasonable steps to enforce a mandate' (Thrush, Long Island Newsday, 12/1)."

I don't think I need to elaborate on just how troubling this is for those who believe in limited government. However, on a purely practical level, it seems likely that it would be quite difficult to find a proper level above which wages would be confiscated to enforce this mandate. It seems Massachusetts is having a similar problem with the issue of what type of insurance is affordable and exactly who should be subject to the individual mandate. And, of course, the Clinton folks don't have anything to say about how this would burden businesses charged with implementing the withholding.

What is perhaps most troubling is not that this type of plan would succeed at the federal level. I don't think it would survive in today's political climate. But there are a variety of state-level politicians who are proposing individual mandates. In the plans I have seen, if details of the mandate's enforcement are given it is usually through the Massachusetts model of denying an noncompliant individual's standard tax deduction. But the garnishing of wages would seem to be a much more efficient way of achieving the goal. With the coming implosion of the Massachusetts plan, it isn't likely that politicians will draw the lesson that an individual mandate is bad policy. Instead, they will look for other ways to implement it. A Hillary-style withholding plan may become the next "innovation" on the state level.