Many congressional Republicans supported the idea of an individual mandate requiring Americans to purchase health insurance - that is, until President Barack Obama became president. Then the idea of an individual became perhaps the most controversial part of the health care reforms signed into law by Obama in 2010.
Republican lawmakers were staunchly opposed to the individual mandate, saying it represented an intrusion on personal liberties by the federal government. The individual mandate was also a key element of the legal challenge before the U.S. Supreme Court.
But a look back at the history of the individual mandate finds that the idea of requiring Americans to purchase health insurance or pay a penalty was first proposed by Republicans in the U.S. Senate in the mid-1990s. President George H.W. Bush also called for such a program.
1993 Individual Mandate Legislation
Some congressional Republicans voiced support for a statutory requirement on Americans to purchase health insurance nearly a decade before Obamacare as an alternative to government-run universal health care.
In 1993, an individual mandate was part of the Health Equity and Access Reform Today Act introduced by Republicans in the U.S. Senate. The bill would have given vouchers to poor Americans so they could afford health insurance, and penalized those who did not purchase coverage. It was introduced as an alternative to President Bill Clinton's proposal requiring employers to insure their workers.
That bill was sponsored by U.S. Sen. John H. Chafee, a Republican from Rhode Island. It never became a law.
Republican Supporters of Individual Mandate in 1993
There were 19 Republican Senators who cosponsored the bill. They were:
- Sen. Robert F. Bennett or Utah
- Sen. Christopher S. Bond of Missouri
- Sen. William S. Cohen of Maine
- Sen. John C. Danforth of Missouri
- Sen. Robert J. Dole of Kansas
- Sen. Pete V. Domenici of New Mexico
- Sen. Dave Durenberger of Minnesota
- Sen. Lauch Faircloth of North Carolina
- Sen. Slade Gorton of Washington
- Sen. Chuck Grassley of Iowa
- Sen. Orrin G. Hatch of Utah
- Sen. Mark O. Hatfield of Oregon
- Sen. Nancy Landon Kassebaum of Kansas
- Sen. Richard G. Lugar of Indiana
- Sen. Alan K. Simpson of Wyoming
- Sen. Arlen Specter of Pennsylvania
- Sen. Ted Stevens of Alaska
- Sen. John Warner of Virginia
- Sen. Hank Brown of Colorado (later withdrew his support)
There were two Democratic cosponsors, Sens. David L. Boren of Oklahoma and Robert J. Kerrey of Nebraska.
Durenberger later told Kaiser Health News that the reason Republicans opposed the individual mandate in the 2010 health care reform law is politics. "The main thing that’s changed is the definition of a Republican," he said.
George H.W. Bush and the Individual Mandate
Bush called for insuring all Americans in his January 1992 State of the Union speech, saying:
"My plan provides insurance security for all Americans while preserving and increasing the idea of choice. We make basic health insurance affordable for all low-income people not now covered. We do it by providing a health-insurance tax credit of up to $3,750 for each low-income family.
"The middle class gets help, too. And by reforming the health insurance market, my plan assures that Americans will have access to basic health insurance even if they change jobs or develop serious health problem. We must bring costs under control, preserve quality, preserve choice and reduce people's nagging daily worry about health insurance. My plan, the details of which I will announce shortly, does just that."
The idea of the individual mandate dates to 1989 and is widely attributed to Mark Pauly, a health-care policy expert who was advising the Bush White House on the issue at the time. Conservative policy experts at the Heritage Foundation and American Enterprise Institute were also said to be developing such a plan at the same time.