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McCaskill's stance on health-care mandate unchanged, aide says

This article first appeared in the St. Louis Beacon, Jan. 6, 2011 - A spokeswoman for U.S. Sen. Claire McCaskill, D-Mo., denied Thursday that the senator is shifting her stance on the new federal health-care law's provision requiring most Americans to purchase health insurance by 2014.

McCaskill voted for the law last year. The web on the left and right has been abuzz over the senator's comments Wednesday on MSNBC, which has been interpreted by some national publications -- notably Politico -- as the senator moving away from the mandate.

Such a shift would be notable because McCaskill has defended the mandate in interviews for more than a year, calling it a necessity if the public wants to prevent insurers from barring coverage on pre-existing conditions.

McCaskill and others, including new Sen. Roy Blunt, R-Mo. (who opposes the health-care law and the mandate), say that a mandate is linked to the pre-existing condition issue because people otherwise would purchase insurance only when they got sick -- further driving up insurance costs overall.

Critics on both sides assert that a shift on the mandate would be further evidence that McCaskill, who is running for re-election in 2012, is trying to distance herself from her party and President Barack Obama, who she strongly supported in 2008.

McCaskill press secretary Maria Speiser said Thursday that the senator's MSNBC comments, in their entirety, "are not significantly different from what she has said in the past."

Here's her MSNBC comments that have sparked the controversy:

Anchor: "Senator, would the people of Missouri like to see Obamacare repealed?"

McCaskill: "I think they don't like the mandate and by a wide margin they voted that way (a reference to Proposition C, which passed handily in Missouri on Aug. 3). I do think we have to look at it to see if there's a different way to make sure to get more people in the pool. What the most popular part of the bill (is, barring) pre-existing conditions, allowing people who have had the nerve to be sick before, allowing them to get insurance, that's the most popular part. That really is what drove the desire for a mandate because you've got to get everybody in the pool. Can you imagine if you could go get car insurance after you had a wreck? Who is going to buy insurance until after they're sick. Maybe there's other ways to get people in a pool other than a mandate -- I hope -- and we need to look at that."

For comparison, Speiser then offered up the text of two McCaskill statements in December on the health-care law and the continued debate:

Radio interview, 12/15"I don't know what the ultimate decision will be by the courts. But I know this, that the most popular thing in the bill is doing away with pre-existing conditions. Allowing people to get insurance even if they've had the nerve to get sick before. The most unpopular thing is the mandate. I have yet to have anybody explain to me, how we can have one without the other. Because obviously if you can wait and get insurance after you're sick, no one is going to buy insurance until they are sick. Which would be just like somebody being about to buy car insurance after they've had a wreck. You can imagine how expensive that proposition would be. It would dry up the private market for insurance. So if we give up the mandate then we must give up on allowing people to be denied coverage because they've had the nerve to ever be sick in their life. ... So if somebody can figure out how we can get more people in the pool which brings down prices for everyone, without any kind of mandate, sign me up."

Statement to the Joplin Globe: "The parameters of the health-care bill will continue to be sorted out in the courts and in Congress. That is one of the reasons we delayed implementation until 2014. I continue to look for ways to allow people with pre-existing conditions to buy insurance without mandating anyone participate. That is a huge challenge because if you could buy insurance after you are sick, no one would buy it until then, and it would be incredibly expensive for everyone."

Overall, said Speiser, "Claire believes the bottom line is that the mandate is unpopular, and if there are other ways to stop insurance companies from discriminating against people with pre-existing conditions, it's worth considering."

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