In the Republican presidential debate Tuesday night, former House Speaker Newt Gingrich acknowledged, apparently in an unguarded moment, that a core element of "ObamaCare," the requirement that all Americans be enrolled in either a private or public health insurance plan, was a proposal originated by the Heritage Foundation, a powerful conservative think tank.
Gingrich made the admission as he was denying former Massachusetts Governor Mitt Romney's accusation that the former Republican leader was once a supporter of the mandate.
I'm sure the other presidential hopefuls on the stage in Las Vegas were holding their breath, praying they would not be asked why they all are now so staunchly opposed to the very notion of such a mandate, which several GOP attorneys general are even alleging in various lawsuits violates the U.S. Constitution. As a result of those lawsuits, the Supreme Court is likely to rule next year on the constitutionality of the mandate and the entire reform law.
The candidates' prayers were answered. Not one of them was asked why an idea conceived more than two decades ago by several conservative economists and favored by Republican lawmakers is a horrible idea now.
If they had been asked and had been honest in their responses, they undoubtedly would have said it is because Barack Obama is not a Republican and also because the mandate, according to almost every poll, is the least popular part of the Affordable Care Act.
The Heritage Foundation was not alone in advocating for an individual mandate, which was the cornerstone of its "Responsible National Health Insurance" plan back in 1991. It was also endorsed by one of the other preeminent conservative and pro-business think tanks, the American Enterprise Institute, which for many years received funding from one of the companies I worked for, CIGNA Corporation. (CIGNA endowed a chair at AEI to honor Wilson Taylor when he retired as chairman and CEO of the company.) You can rest assured that AEI would never have supported an individual mandate if insurance companies hated the idea.
Fast forward to 2009. The insurance industry was so determined to have an individual mandate included in the reform bills working their way through Congress that it sent a pro-mandate emissary to the White House several times to persuade President Obama to embrace the concept -- which Obama had denounced. Obama said during the presidential campaign that he did not think Americans should be forced to buy something they couldn't afford. But former Aetna CEO Ron Williams, who, according to visitor logs, made at least a half dozen trips to the White House after Obama was elected, carried the insurance industry's message that a mandate coupled with subsidies from the government to help people pay for coverage would solve the problem of affordability.
Thus persuaded, the White House threw its weight behind the concept, and, of course, the bill Obama signed in May of last year included it. I can imagine that at least some mandate supporters also led the president to believe -- or at least hope -- that, since the mandate was originally a Republican idea, his reform proposal would win the support of enough GOP members of the House and Senate that he could claim bipartisan support for his legislation. No such luck.
The idea of the mandate dates back to 1989 when Stuart Butler and Edmund Haislmaier of the Heritage Foundation proposed it in an article entitled, "A National Health System in America." The moniker Responsible National Health Insurance debuted two years later when economists Mark Pauly, Patricia Danzon, Paul Feldstein and attorney John Hoff expounded on the idea in an article published first by the Heritage Foundation and, in an expanded version, by AEI in 1992.
The GOP was so fond of the idea that Sen. John H. Chaffee of Rhode Island and several other Republicans introduced legislation during the 1993-94 debate on the Clinton health care plan to require individual households to obtain coverage for acute and emergency care. Out-of-pocket expenses could not exceed what each household could afford. The provisions of the Affordable Care Act pertaining to the mandate surely were modeled after Chaffee's bill.
The proponents of the mandate said at the time that they felt it was necessary to deal with the growing problem of "free riding," or uninsured people accessing health care but having no insurance or other means to pay for medical treatment once they had received it. They also proposed it as a "free-market" counter proposal to a single-payer system like Canada's, which many Democrats supported (and still do).
AEI even dealt with the argument against the mandate we are hearing today: that it infringes on our freedom to remain uninsured if that's what we want to do. AEI responded that society already interferes with individual freedoms by requiring Americans to contribute to the Social Security system.
So the next time you hear a Republican candidate denounce ObamaCare and the individual mandate around which it is built, know that it was an idea embraced by leading conservatives and GOP members of Congress not that long ago.
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An idea (from 20 years ago) that they never pushed. So you take one point out of this, and try to say the reps were for obamacare in its entireity from this?
Since the mandates in the new health care law (you notice it is not an insurance law) describes the kind of health care that must be covered it kind of misses the point.
Now, let's be clear, I am an independent, hate both Dems and Repubs equally. I like the basic idea that the Heritage Foundation has put out. Mandated coverage for emergencies, paid in through tax dollars, perhaps even some basic health care like free clinics for checkups and the like. The rest is covered by either your pocket book or some sort of supplemental pre-paid health care (what we all talk about as health insurance today).
That is it. That is the starting point we should all line up on.
The mandates are poorly formed and do not do enough. As a person who has lived in a country that has universal health care I am appalled at what the people of the US are offered. We are going to go broke because no politician will ever be allowed to propose what needs to be done. Either we cap health care costs and start to bring them down or we go for full blown universal care. The system we have today is health care welfare. If you don't want to pay you don't have to. You just go down to the emergency room and force the rest of us to pay. I applaud the efforts by the current administration to initiate change. But what we have now is not nearly enough but it is only THE START. It has to start somewhere and since every miles long journey starts with a small step it is something we can embrace and build upon. At the current rate in 20 years we will have to decide between food and health care. That isn't going to get it.
Single payer would be constitutional.
Even raising taxes and issuing vouchers to then be used to buy private insurance would constitutional.
The mandate is not.
Furthermore, if an individual doesn't purchase insurance they are fined. The government, as you admit, has the power to tax. It could be seen as using the constitutional ability to tax to encourage the purchasing of insurance. Either way, individuals still have a choice.
I am just noting these points to show there are convincing arguments that the individual mandate is actually constitutional, and at the very least it is too complicated of an issue to categorically say that the mandate is not constitutional. Ultimately, the court will decide, and it will be interesting to see how the come down.
B- The commerce clause gives Congress the power to REGULATE interstate commerce. It does NOT give Congress the power to COMPEL commerce.
I'll say again...they can make rules that you must follow when you choose to engage in commerce. They have no right to force you to engage in commerce.
C- You can call a fine a tax...but's its still a fine.
Had they raised taxes and issued vouchers, that would have been Constitutional.
Ordering citizens to purchase a product from a private company or else face penalties is not.
Is similar to NEWT's reaction in the Las Vegas debate.
They were only FOR the Individual Mandate when there was no possibility that it would actually be enacted.
AS NEWT MADE IT ABUNDANTLY CLEAR, the Heritage Foundation was only FOR the Individual Mandate in reference as a "STRAW-MAN" position to be used against the 1992-3 Clinton version of Universal HealthCare
So, instead of bemoaning it's inevitable failure, we should embrace the collapse of the HCRA as an opportunity to move towards a sustainable reform plan that moves us closer to a single-payer system.
Promoted by two pro-corporate parties.
Republicans won't rescind the mandate.
when their insurance company donors obviously want it so badly.
It could actually work and without nationalizing health insurance companies ---
if there were real controls on insurance like in Massachusetts --
that clearly just won't happen.
I don't understand why anyone who votes Republican thinks he's supporting free enterprise.
But then, what Obama voters think they are supporting is even more unfathomable ---
Do most people get their information from Fox and MSNBC, now?
. . . VERSION OF "FREE ENTERPRISE"
Their preferred version of "Free Enterprise is most commonly referred to as:
. . . PAY TO PLAY
GOVERNMENT FOR SALE TO THE HIGHEST BIDDER
The Republican Party "wants not so much to reform government,
. . as to auction off its parts and distribute the proceeds to its corporate backers"
-Frank Rich
Please show me in the Constitution where it gives Congress the right to force citizens to purchase a product from a private company.
President Reagan signed into law a bill requiring hospitals and doctors to provide free emergency care.
They don't have the right to COMPEL anyone to engage in commerce.
Big difference.
Now, what about the mandate?