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Is the individual mandate a conservative idea?

By - Last modified: March 29, 2012 at 8:46 AM

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Yes, it is.

The rationale for the individual mandate in the Patient Protection and Affordable Care Act of 2010 is grounded in conservative ideas and Republican legislation.

On Oct. 22, 1989, the conservative Heritage Foundation originated and developed the individual mandate in a report entitled, “Assuring Affordable Health Care for All Americans.”

“A mandate on households certainly would force those with adequate means to obtain insurance protection,” according to the report.

Then, on March 5, 1992, the Heritage Foundation published a second report, “The Heritage Consumer Health Choice Plan,” which promoted reforms in insurance markets. Unless already covered by a government insurance program — Medicare, Medicaid, Veterans Administration — or by an employer, the “private insurance market would be reformed to make a standard basic package available to all at an acceptable price.”

In 1993, conservative Republicans introduced two reform bills that included the individual mandate as the solution to addressing skyrocketing costs and rising numbers of the uninsured. On Nov. 20, 1993, Republican Sen. Don Nickles and 24 Republican co-sponsors introduced the Consumer Choice Health Security Act, which mandated “employers withhold health insurance premiums from employee wages” and “notify employees of their right to claim an advance refundable tax credit for such premiums.”

Three days later, Republican Sen. John Chafee and 18 Republican co-sponsors introduced the Health Equity and Access Reform Today Act. This bill advanced the same goals of universal coverage in President Barack Obama's Patient Protection and Affordable Care Act.

“Each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005,” the Republican bill stated.

It also “provides an exception for any individual who is opposed for religious reasons to health plan coverage, including those who rely on healing using spiritual means through prayer alone.”

The sponsors and advocates for those two bills were senators who now oppose the individual mandate in the Patient Protection and Affordable Care Act, namely Orrin Hatch (R-Utah) and Charles Grassley (R-Iowa), as well as former Sens. Robert Bennett (R-Utah) and Christopher Bond (R-Mo.).

Not one Republican voted for the Patient Protection and Affordable Care Act in 2010, even though it is a conservative Republican law. Obama simply adopted Republican policies to pass the same health insurance reform measure that conservatives now see as unconstitutional before the Supreme Court.

“Nobody was saying that it was creeping socialism or unconstitutional at the time. A lot of conservatives were for it,” former Republican Sen. Robert Bennett said.

In 2007, Mitt Romney defended the individual mandate in the Massachusetts health reform law as “ultimate conservatism.”

What's changed?

The political environment, not the idea or the policies, is incredibly toxic. Situational politics explains why every elected Republican now opposes a conservative Republican idea.

It's not about health care, it's about politics.

Chris Dolan is associate professor of political science at Lebanon Valley College and the author of “Striking First,” “In War We Trust” and “The Presidency and Economic Policy.”

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