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Thursday, June 16th, 2011
Baton Rouge, Louisiana
ARE REPUBLICANS FLIP FLOPPING ON
HEALTH INSURANCEÂ MANDATES?
Remember the old knock on presidential candidate John Kerry back in the 2004 election? “I was for it before I was against it.”  Today, about the single worst charge that can be made against any conservative republican presidential candidate is that they support requiring Americans to buy health insurance. But for decades, the Republican leadership in Washington embraced and championed individual mandates”¦well, that was before they “saw the light,” and flip-flopped against such a requirement. As Ricky Ricardo used to say: “Lucy, you got some explainin’ to do.”
The push towards mandated health care began back in the mid 1980s under President Ronald Reagan when he signed legislation that mandated free health care for all who seek it. That law, the Emergency Medical Treatment and Labor Act (EMTALA), was the largest expansion of government mandated health care since Medicare. But from the start, this new law engendered controversy from conservative economists. Their concern was that the system was not encouraging individual responsibility. Their thinking was that many people would not purchase health insurance, so the taxpayer would get stuck with the medical bills.
From that point on, a whole host of Republican congressional leaders called for mandated health coverage. Here is House Speaker Newt Gingrich in 2007 — “Personal responsibility extends to the purchase of health insurance. Citizens should not be able to cheat their neighbors by not buying insurance, particularly when they can afford it, and expect others to pay for their care when they need it.” An “individual mandate” should be applied.
In 2008, Tommy Thompson, The Secretary of Health and Humans Services under President George W. Bush, said, “Just like people are required to have car insurance, they should be required to have health insurance.” Add to that list of supporters former Senate majority Leader Dr. Bill Frist of Tennessee, and all the Senators who co-sponsored legislation with an individual mandate — Senator Lamar Alexander (R-Tenn.), Senator Chuck Grassley (R.-Iowa), Bob Bennett (R-Utah), Mike Crapo (R-Idaho), Lindsey Graham (R-S.C.), Judd Gregg (R-N.H.).
Here’s what Senator Grassley said just two years ago on Fox News: “There isn’t anything wrong with an individual mandate, except some people look at it as an infringement on individual freedom. But when it comes to states requiring it for automobile insurance, the principal then ought to lie [be] the same for health insurance. Because everybody has some health insurance costs, and if you aren’t insured, there’s no free lunch. Somebody else has to pay for it”¦.I believe there is bipartisan consensus to have individual mandates.”
As these comments and many others by Republicans and numerous conservative think tanks have pointed out, there is a strong case for personal responsibility. Why should a certain portion of the population ignore their healthcare protection, then have an accident or get sick, and run to the emergency room for treatment, forcing you and me to pay their bill? If we have to pay the piper, then why doesn’t everyone?
There is little hue and cry over mandated automobile insurance. Everyone is required to be insured, so that if you are in an accident, and it’s not your fault, the other guy has to step up to the plate and pay you damages. What’s fair for one, is fair for all. Most of us don’t want to subsidize the uninsured driver, so why would we want to subsidize the irresponsible guy who just doesn’t care enough to buy health insurance? If someone can’t afford the cost, then perhaps there should be a subsidy. But everyone should pay something. That’s called being responsible. And that is why in the past, so many conservative republicans embraced the individual mandate.
What about property insurance? Just try to go to a financial institution to borrow money for a new home, or for refinancing. No property insurance? Forget it. And isn’t it ironic that the same politicians who are opposing government mandated health insurance are leading the cry for property bailouts. No help when you get sick, but members of congress demand that the government cavalry come charging in when a flood or hurricane hits.  If you live in my part of the country and don’t responsibly buy flood insurance, then government bailouts are both expected and demanded.
Following Hurricane Katrina, U.S. Senator Trent Lott’s Mississippi beachfront home was destroyed, and he had not purchased flood insurance. So he introduced legislation to provide retroactive flood insurance to victims like himself. He was joined in support by his Senate colleague, Thad Cochran and Governor Haley Barbour. Make the government bail out those who didn’t look out for themselves. But they now strongly oppose any mandated health coverage.
And the flood insurance, itself, is highly subsidized by the federal government. Now catch the irony here.  With health insurance, the insurance company will reject you if you have a pre-existing condition. No subsidy and no coverage. But for property insurance, it’s just the opposite. If you live in a part of the country that floods or is prone to hurricanes, your flood insurance is even cheaper because it is subsidized by the government. Go figure.
In testimony before the Senate Judiciary Committee last month, former Solicitor General Walter Dellinger summed up the dilemma well. “There is nothing else in our economy where an individual who has made no preparation can go in and get $1 million of goods and services passed on to them at taxpayer expense.” That means the system struggles with free riders –people who would have society pay for their care, rather than pay for it themselves.
Will the health mandate stand up to judicial review? Right now, each side has two victories in the lower courts. The challenge to the existing mandate is a dead cinch to end up in the U.S. Supreme Court. And it’s also a certainly that Justice Anthony Kennedy will be the swing vote. No good odds on which way the Justice will vote.
Of course party politics plays no role in the current debate. Can you envision the republican Senator looking across the aisle in the nation’s capitol and saying, “Actually, I’m voting against any mandate, before I vote for it, when a Republican is back in the White House?” And you can just hear his democratic colleague retort, “Well, I’m voting for it, after I voted against it, back when you voted for it, when a Republican was in the White House.” Is there any wonder why the country is so enmeshed in gridlock?
*****
If the administration wants cooperation, it will have to begin to move in our direction.
Senate Minority Leader Mitch McConnell
Peace and Justice
Jim Brown
Jim Brown’s syndicated column appears each week in numerous newspapers and websites throughout the South. You can read all his past columns and see continuing updates at www.jimbrownla.com. You can also hear Jim’s nationally syndicated radio show each Sunday morning from 9 am till 11:00 am, central time, on the Genesis Radio Network, with a live stream at http://www.jimbrownla.com. The show is televised at http://www.justin.tv/jimbrownusa.