Mandate That Americans Buy Health Insurance Originated With GOP
The part of the health care overhaul about which Republicans object the most was one they originated. They have likened the requirement that Americans have health insurance to fascism and tyranny, but never used those terms when they proposed it. And it was proposed as an alternative to President Clinton’s attempted health care overhaul. Republicans were for it before they were against it.
Mitt Romney, weighing another run for the GOP presidential nomination, signed such a requirement into law at the state level as Massachusetts governor in 2006. At the time, Romney defended it as “a personal responsibility principle” and Massachusetts’ newest GOP senator, Scott Brown, backed it. Romney now says Obama’s plan is a federal takeover that bears little resemblance to what he did as governor and should be repealed.
Starting in 2014, the new law will require nearly all Americans to have health insurance through an employer, a government program or by buying it directly. That year, new insurance markets will open for business, health plans will be required to accept all applicants and tax credits will start flowing to millions of people, helping them pay the premiums.
Those who continue to go without coverage will have to pay a penalty to the IRS, except in cases of financial hardship. Fines vary by income and family size. For example, a single person making $45,000 would pay an extra $1,125 in taxes when the penalty is fully phased in, in 2016.
A requirement for coverage is needed because if people put off getting covered until they’re sick, insurance can’t work economically.
In the early 1970s, President Richard Nixon favored a mandate that employers provide insurance. In the 1990s, the Heritage Foundation, a conservative think tank, embraced an individual requirement. Not anymore.
“The idea of an individual mandate as an alternative to single-payer was a Republican idea,” said health economist Mark Pauly of the University of Pennsylvania’s Wharton School. In 1991, he published a paper that explained how a mandate could be combined with tax credits — two ideas that are now part of Obama’s law. Pauly’s paper was well-received — by the George H.W. Bush administration.
“It could have been the basis for a bipartisan compromise, but it wasn’t,” said Pauly. “Because the Democrats were in favor, the Republicans more or less had to be against it.”Click here for reuse options!
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