Gingrich: 'Unconstitutional' Insurance Mandate 'Started As Conservative Effort to Stop Hillarycare'

By Terence P. Jeffrey | December 11, 2011 | 2:54pm EST

Mitt Romney and Newt Gingrich (AP Photo)

[This story has been updated.]

( - Former House Speaker Newt Gingrich on Saturday defended his previous support of a federal mandate requiring people to buy health insurance by saying that "virtually every conservative saw the mandate as a less dangerous future" than the health-care plan being advanced by then-First Lady Hillary Clinton in 1993 and that the idea of mandating that people buy health insurance "started as a conservative effort to stop Hillarycare in the 1990s."

While it is true that it in 1989 the Heritage Foundation published a health-care reform plan that called for mandating that all American households purchase health insurance, the plan did not gain many supporters in Congress.

In fact, the principal congressional advocate of an individual health insurance mandate at the time Hillarycare was being debated in Congress in 1993 was Sen. John Chafee--a liberal Republican from Rhode Island. Chafee later said he abandoned his plan for an individual mandate because, at the time, he could not get support for it on either the right or the left.

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As recently as this May, Gingrich himself defended what he called a "variation" on the insurance mandate.

On Saturday, however, Gingrich said: “It’s now clear that the mandate, I think, is clearly unconstitutional.”

Gingrich explained the evolution of his view on the individual mandate in a Republican presidential debate from Des Moines, Iowa, that was broadcast Saturday night on ABC.

"I just wanted to make one point that is historical,” Gingrich said in the debate. “In 1993, in fighting Hillarycare, virtually every conservative saw the mandate as a less dangerous future than what Hillary was trying to do. The Heritage Foundation was a major advocate of it. After Hillarycare disappeared, it became more and more obvious that mandates had all sorts of problems built in to them. People gradually tried to find other techniques. I frankly was floundering trying to find a way to make sure that people who could afford it were paying their hospital bills, while still leaving an out for libertarians to not buy insurance. And that’s what we were wrestling with. It’s now clear that the mandate, I think, is clearly unconstitutional. But it started as conservative effort to stop Hillarycare in the 1990s.”

In an Oct. 3, 1993 appearance on NBC’s “Meet the Press,” Gingrich said that he was for the federal government requiring individuals to buy health insurance and then providing government subsidies to people on sliding scale to help them buy it. The health-care bill that President Barack Obama signed in March 2010 does require individuals to buy health insurance and will provide government subsidies to people on a sliding scale to help them buy it.

“I am for people, individuals--exactly like automobile insurance--individuals having health insurance and being required to have health insurance,” Gingrich said on "Meet the Press" in 1993. “And I am prepared to vote for a voucher system which will give individuals, on a sliding scale, a government subsidy so we insure that everyone as individuals have health insurance.”

When Gingrich appeared on “Meet the Press” on May 15 of this year, host David Gregory confronted him with his 1993 statement advocating an individual health insurance mandate backed by federal subsidies.

On this 2011 program, Gingrich said, “I've said consistently we ought to have some requirement that you either have health insurance or you post a bond.”

Gingrich described this as a “variation” on the individual mandate. He did not say where in the U.S. Constitution the federal government was authorized to tell individuals they had to purchase health insurance or post a bond. Nor did he express any concern that this idea he had “consistently” supported raised any constitutional concerns.

Gingrich also said during his May 15, 2011 appearance on “Meet the Press” that he would not use the insurance mandate as an issue against former Massachusetts Gov. Mitt Romney—who had signed a law in Massachusetts requiring individuals to buy health insurance and providing government subsidies on a sliding scale, determined by income, to help people buy insurance.

“What you advocate there is precisely what President Obama did with his healthcare legislation, is it not?” Gregory asked Gingrich on that May 15, 2011 program.

“No, it's not precisely what he did,” Gingrich said.

“In the first place, Obama basically is trying to replace the entire insurance system, creating state exchanges, building a Washington-based model, creating a federal system,” said Gingrich. “I believe all of us--and this is going to be a big debate--I believe all of us have a responsibility to help pay for health care. I think the idea that—"

“You agree with Mitt Romney on this point?” asked Gregory.

“Well, I agree that all of us have a responsibility to pay--help pay for health care,” said Gingrich. “And, and I think that there are ways to do it that make most libertarians relatively happy. I've said consistently we ought to have some requirement that you either have health insurance or you post a bond or in some way you indicate you're going to be held accountable.”

Gregory asked: “But that is the individual mandate, is it not?”

“It's a variation on it,” said Gingrich.

“And so you won't use that issue against Mitt Romney?” asked Gregory.

“No,” said Gingrich. “But it's a system which allows people to have a range of choices which are designed by the economy. But I think setting the precedent--you know, there are an amazing number of people who think that they ought to be given health care. And, and so a large number of the uninsured earn $75,000 or more a year, don't buy any health insurance because they want to buy a second house or a better car or go on vacation. And then you and I and everybody else ends up picking up for them. I don't think having a free rider system in health is any more appropriate than having a free rider system in any other part of our society.”

In 1989, the Heritage Foundation published a report entitled, "A National Health System for America." It was edited by Stuart Butler, the director of domestic policy studies at Heritage, and David Haislmaier, a health care policy analyst at Heritage.

A section of the report authored by Butler recommended that: "Every resident of the U.S. must, by law, be enrolled in an adequate health care plan to cover major health care costs."

"Under this arrangement, all households would be required to protect themselves from major medical costs by purchasing health insurance or enrolling in a prepaid health plan," the Heritage report said. "The degree of financial protection can be debated,  but the principle of mandatory family protection is central to a universal health care system in America."

This plan described by Stuart Butler at the Heritage Foundation did not catch fire with conservatives.

By 1993, when First Lady Hillary Clinton was promoting her universal health care plan, the principal advocate in Congress of a federal mandate that individuals buy health insurance was not a conservative, but was Sen. John Chafee, a liberal Republican from Rhode Island. Chafee himself would admit that: "The right was against it."

Chafee discovered this after he initially proposed a health-care reform plan that included an individual mandate. However, that plan failed to gain momentum.

On June 27, 1994, USA Today published an article headlined, “Chafee stakes out middle ground.”

“Sen. John Chafee is known on Capitol Hill as a bridge-builder and a longtime health-care crusader,” reported USA Today. “Last week, those traits merged as the Rhode Island Republican forged a health-care reform compromise among fence-sitters on the Senate Finance Committee who oppose requiring employers to pay for their workers' insurance.”

“Gone from Chafee's plan is any talk of a mandate,” USA Today said. “After Clinton proposed requiring employers to pay at least 80% of workers' premiums in order to achieve universal coverage, Chafee had countered with a plan to require individuals to buy insurance. But the individual mandate fell flat.”

“‘There was no constituency for it," Chafee said, according to USA Today. ‘The right was against it. The left was against it.’”

Appearing on The MacNeil/Lehrer NewsHour on Aug. 19, 1994, Chafee similarly asserted that he could not find support in Congress for his idea to enact an individual health insurance mandate—so he had abandoned the idea.

“Then, Senator, you once favored an individual mandate requiring individuals to, to purchase health insurance,” asked host Kwame Holman. “Do you no longer think that's necessary or achievable politically?”

“Frankly, it--we just--I couldn't find support for it,” Chafee said. “There's no point in coming up with something that everybody seems to be against. We talked about that in our mainstream caucus but we just felt it wasn't going to fly, and so we pulled it out.”

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