White House Gives Example of Alternative to Individual Mandate for States

Today, President Obama announced that he supports a bill by Senators Wyden and Brown which would move up the date states would become eligible to receive the so-called "state innovation waiver. State innovation waivers would be granted by the Department of Health and Human Services (HHS) and would waive some of the requirements of Obamacare. States that wish to receive a waiver would apply to HHS by submitting their alternative legislation. A White House “Fact Sheet” says that the President, “belie[ves] that States should have the power and flexibility to innovate and find the health care solutions that work best for them. . . .” But, based on the requirements of the waiver, very little flexibility and power is actually being given. The waiver requires that the state alternative:
  1. Must have “coverage [benefits] at least as comprehensive” as Obamacare;
  2. Must be as affordable to the consumer as Obamacare;
  3. Must cover at least as many people as Obamacare; and
  4. Must not increase the federal deficit.
Because of these restrictions, columnist Ben Domenech responds to those who claim states can opt out of the individual mandate by saying:
“[I]t is hard to see all but a few rare circumstances where a state would apply for this exemption and move toward a pro-market solution. You would have to prove that you would have a greater number of people purchase a product than you would by legally requiring them to purchase that product.”
The White House's fact sheet also contains a few examples of potential state innovation waiver requests including this one:
Alternatives to the individual responsibility provision – such as automatically enrolling individuals in health plans – that achieve similar outcomes.
What does this mean? Who does the automatic enrolling? Presumably, it must be the government. If it were employers, then you’d have fewer people enrolled than with an individual mandate, since not everyone is employed. And if the White House means to suggest that in order to get a waiver from the individual mandate, state governments would have to automatically enroll individuals in health plans—is that not the very definition of a single payer or government-run health plan?