Affordable Care Act
- 1989 ..... the conservative Heritage Foundation proposed an individual mandate as an alternative to single-payer health care
- championed for a time by conservative economists and Republican senators as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of free rider problems
- President Bill Clinton proposed a healthcare reform bill in 1993 that included a mandate for employers to provide health insurance to all employees through a regulated marketplace of health maintenance organizations, Republican Senators proposed an alternative that would have required individuals, but not employers, to buy insurance.
- the 1993 Republican alternative, introduced by Senator John Chafee as the Health Equity and Access Reform Today Act, contained a "universal coverage" requirement with a penalty for noncompliance—an individual mandate—as well as subsidies to be used in state-based 'purchasing groups'.
- advocates for the 1993 bill included prominent Republicans who today oppose a mandate, such as Senators Orrin Hatch, Chuck Grassley, Bob Bennett, and Kit Bond. Of the 43 Republicans Senators from 1993, 20 supported the HEART Act.
- at the time of these proposals, Republicans did not raise constitutional issues with the mandate; Mark Pauly, who helped develop a proposal that included an individual mandate for George H.W. Bush, remarked, "I don’t remember that being raised at all. The way it was viewed by the Congressional Budget Office in 1994 was, effectively, as a tax."
- Romney's implementation of the 'Health Connector' exchange and individual mandate in Massachusetts was at first lauded by Republicans. During Romney's 2008 presidential campaign, Senator Jim DeMint praised Romney's ability to "take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured."
- Romney said of the individual mandate: "I'm proud of what we've done. If Massachusetts succeeds in implementing it, then that will be the model for the nation."
http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act