Stewart poked fun at the healthcare insurance exchanges' shaky launch last week, joking it would take Sebelius longer to sign up for Obamacare than it would take him to "try to download every movie ever made."
The comedian turned serious when challenging Sebelius on the individual mandate, which requires nearly all Americans to have health insurance by 2014 or face a penalty, unlike businesses who employ more than 50 people, whose mandate was delayed in July for a year.
"If I'm an individual that doesn’t want this, it would be hard for me to look at a big business getting a waiver and not having to do it," Stewart said. "I would feel like you are favoring big business because they lobbied you, but you’re not allowing individuals that same courtesy.”
Reaction to the interview has Sebelius getting steamrolled by Stewart's argument. But while Sebelius didn't really answer Stewart's question, he also mischaracterized the distinction between the two parts of the law.
Health policy scholars have explained the difference between the individual mandate and the employer mandate, not as two equal components getting different treatment, but one as far bigger and more important than the other.
"Just because 'individual mandate' and 'employer mandate' sound the same doesn’t mean that they are," explained health policy scholar Adrianna McIntyre. "Equating the two reaches an impressive new level of political theatre -- and demonstrates willful ignorance of the motivations behind each mandate."
The employer mandate, as she explains, requires companies employing more than 50 people to provide insurance for all full-time workers or face a penalty. That portion of the law is relatively inconsequential to the overall implementation, since most of the companies that fall under the employer mandate already provide health insurance to their employees.
Conversely, the individual mandate is the means by which the entire law functions. In order to keep premiums down for everybody, the risk pool -- the total group covered by insurers -- must be big enough and have enough healthy and relatively inexpensive people to subsidize the cost of the smaller group of sicker and more expensive people.
The individual mandate seeks to prevent only sick people from purchasing insurance, and thus driving up the cost to unaffordable heights for everyone.
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