The reliance on Congress also helps the administration overcome the hangover from the campaign. During the primaries, Hillary Clinton attacked Obama's health care plan for lacking a mandate and, thus, not covering every American. "If you don't start with the goal of covering everybody," Clinton said, "you'll never get there." In reply, the Obama team struck back with charges that Clinton would "force people to get health insurance" and require "harsh, stiff penalties on those who don’t purchase it."

But even in the heat of the campaign, Obama's advisers sought to quietly signal their candidate's openness to an individual mandate. "The fact is," said David Cutler, the Harvard health economist who served as one of Obama's key health care advisers, "the policy differences on the mandate issue aren’t that large at all. Senator Obama believes they’re an option down the road, if other approaches don’t work.” And administration insiders then and now emphasized that the Obama campaign didn't start the mandate fight: They felt blindsided by the attacks and compelled to respond in kind. But it was a question of politics, not of principle. In principle, they were open to a mandate if they could be convinced that it was superior policy and superior politics.

Evidently, they're convinced.