Sen. Claire McCaskill’s once rock-solid support for a key component of President Barack Obama’s national health care reform law appears to be wavering.
While saying she still backs the individual mandate portion of the law — the controversial section requiring that virtually every individual carry health insurance or pay a penalty — the Missouri Democrat said Thursday that she is searching for alternatives.
“I think there are different things we could look at to see if they would work, and I’m open to that,” she said.
Passed in March, health care reform remains a political lightning rod in Washington. House Republicans continue to promise a vote to repeal the law, although it would face an uphill battle in the Democrat-controlled Senate. And even if it did pass in Congress, Obama almost certainly would veto it.
McCaskill, a freshman Democrat and Obama ally, is expected to face a difficult re-election race in 2012, with her support for the health care law destined to become a major issue. On Thursday, University of Virginia political scientist and election prognosticator Larry Sabato described her as “very vulnerable” and already in a “toss-up” race.
Republicans pounced on McCaskill’s comments, first made on MSNBC.
“It sounds like Sen. McCaskill’s re-election strategy is based on her hope that Missourians have a very short memory,” said Chris Bond, spokesman for the National Republican Senatorial Committee. “Of course, voters know that McCaskill gave President Obama the crucial 60th vote to ram the Democrats’ government health care bill into law against their wishes.”
In Missouri, Republican Sarah Steelman, a former state treasurer who already has announced plans to run for McCaskill’s seat, wrote on Twitter that McCaskill backed “Obamacare” but now was “looking at alternatives.”
“Try following the Constitution and honoring freedom,” Steelman wrote.
McCaskill insisted, however, that she has not changed her position on health care reform. She has talked about looking for ways to improve the new law since it passed.
“It’s kind of interesting to me,” she said of GOP critics. “I’m not sure in the history of politics has the phrase ‘I think we ought to look at an issue and keep working on it’ become a ‘gotcha’ moment.
“Of course I want to continue to improve the bill if we can.”
In December, Judge Henry Hudson of Virginia declared the mandate unconstitutional, casting doubt on the law’s legality. Missourians overwhelmingly rejected the new health care law in an August vote.
Asked for her reaction at the time of that vote, McCaskill responded: “Message received.” But she continued expressing strong support for the mandate as recently as December.
“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,” she said at the time.
That support, she said Thursday, remains unchanged if no viable alternative can be found. And she’s not sure that one can be found.
One aspect of the law that cannot change, McCaskill said, is the ability of those with pre-existing medical conditions to buy affordable health coverage. The thinking in Congress, she said, was that the only way to cover them was to require otherwise healthy people to also buy health insurance.
Only with a mandate, Democrats argued, could insurance premiums remain affordable.
But Republicans unanimously opposed the bill, with many pointing to the individual mandate as the reason. The mandate, some contended, was an encroachment on individual freedom.
McCaskill said that if lawmakers can find a way around the individual mandate that still results in a sizable pool of Americans getting health coverage, she’s all for it. Such a method could involve financial incentives that would attract otherwise healthy Americans to sign up.
The individual mandate goes into effect in 2014.
“We can’t repeal the bill because there are too many good things in it that are very, very good and important,” McCaskill said. “But should we work in a bipartisan way to make changes? Absolutely.”
The goal, she said, should be to keep “the most popular part of the bill (covering those with pre-existing conditions who are often denied coverage now) and get rid of the least popular part of the bill (the individual mandate) without going to a government-run system.
“My priority,” she added, “is making sure that people with pre-existing conditions can get insurance. If that requires that people participate — like we require people to participate in Medicare and Social Security — then I think we need to go down that path.
“But obviously if we can accomplish the number one goal, which is to be able to cover people with pre-existing conditions without that, that would obviously be preferable, and I’m going to continue work on that to see if it’s possible.”