No Health Care? Expect A Requirement To Get It

Even so, at least some conservative Republicans likely will argue that Obama is stepping on individual rights by mandating coverage, expanding government's hand in the health care industry and creating a pathway to socialized medicine. Just last week, congressional conservatives offered their own plan. It would not mandate people to carry insurance.

But even Republicans say a requirement is likely.

"I believe there is a bipartisan consensus to have individual mandates," says Iowa Sen. Chuck Grassley, the top Republican on the Senate Finance Committee. The reason is fairness, he says: "Everybody has some health insurance costs, and if you aren't insured, there's no free lunch. Somebody else is paying for it."

It's support like this that's meant Obama has been able to shift positions with seemingly little political peril.

"Because there's a consensus among both the stakeholders and the legislators that this is the direction to go, the president essentially doesn't have a reason not to support it," said Judy Feder, a senior health care official under Clinton who now is at the liberal Center for American Progress.

Still, Congress must figure out how to enforce such a mandate, eligibility for a so-called hardship waiver, tax credits so people can afford health care and subsides for the poor to help them buy coverage.