Reversal On Health Mandate Came Late For Gingrich And Romney : Shots - Health News Both Newt Gingrich and Mitt Romney once supported the requirement that almost everyone have health coverage — a key plank of the federal overhaul. And both GOP presidential hopefuls stuck with that position a lot longer than you might realize.
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Reversal On Health Mandate Came Late For Gingrich And Romney

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Reversal On Health Mandate Came Late For Gingrich And Romney

Reversal On Health Mandate Came Late For Gingrich And Romney

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This is MORNING EDITION, from NPR News. I'm Linda Wertheimer.


And I'm Steve Inskeep.

The Republican candidates for president all agree on one thing: They all pledge to repeal last year's health care overhaul. But for some, that is an awkward place to stand.

WERTHEIMER: President Obama's health care law is built around a requirement that most Americans must eventually have health insurance, or pay a penalty. Republicans fiercely oppose that mandate, but the mandate was originally a Republican idea. It was part of the health care law signed then-Massachusetts Governor Mitt Romney.

INSKEEP: Yesterday, The Wall Street Journal unearthed a 2006 newsletter in which Newt Gingrich embraced that law. And it turns out, you need not go back to 2006 to hear both men defend the mandate.

Here's NPR's Julie Rovner.

JULIE ROVNER, BYLINE: So just how much do leading GOP candidates Mitt Romney and Newt Gingrich dislike the law they refer to as Obamacare? Well, here's Romney a couple of weeks ago at a debate in Des Moines, Iowa.


MITT ROMNEY: It is wrong for health care. It's wrong for the American people. It's unconstitutional. And I'm absolutely, adamantly opposed to Obamacare.

ROVNER: And here's Gingrich in a video from his campaign website.


NEWT GINGRICH: I am for the repeal of Obamacare, and I'm against any effort to impose a federal mandate on anyone because it is fundamentally wrong and, I believe, unconstitutional.

ROVNER: By now, it's pretty common knowledge that both candidates once supported the so-called individual mandate that's at the heart of the federal health law. It's also at the heart of the law Romney signed as governor of Massachusetts in 2006.

And Gingrich, at the Des Moines debate earlier this month, agreed he'd supported the idea when he fought President Clinton's health overhaul plan.


GINGRICH: In 1993, in fighting HillaryCare, virtually every conservative saw the mandate as a less-dangerous future than what Hillary was trying to do.

ROVNER: But the fact is both candidates still supported the idea of requiring people to have insurance a lot more recently. Gingrich said this on NBC's "Meet the Press" just last May.


GINGRICH: I've said consistently we ought to have some requirement, that you either have health insurance, or you post a bond...


GINGRICH: ...or in some way you indicate you're going to be held accountable.

GREGORY: But that is the individual mandate, is it not?

GINGRICH: It's a variation on it.

ROVNER: Meanwhile, former Governor Romney, who continues to defend his state's individual mandate, has maintained recently that he wouldn't support extending it nationwide. But that's not what he said in March 2010, just days after the federal bill became law, in an interview comparing the two.


ROMNEY: Now, the similarities are that we have an incentive for people to become insured, and the incentive works. We have 98 percent of our citizens in Massachusetts that are insured. So that's working.

ROVNER: Romney went on to say he actually wouldn't repeal the entire federal law, but, quote, "repeal the bad, and keep the good." So why the very recent turnaround?

PATRICIA DANZON: You know, it's hard for me to not to be cynical about this, frankly.

ROVNER: That's Patricia Danzon. She's a professor of health management at the Wharton School at the University of Pennsylvania. More importantly, she helped invent the individual mandate back in the late 1980s as one of a quartet of free-market academics. It's the plan that ultimately became the Republican alternative to President Clinton's proposal.

DANZON: Our objective was to try to design a health care system that would rely on competitive markets to provide the insurance, but would achieve universal coverage.

ROVNER: Without having the government run it. This, of course, was happening at a time when the main Democratic plan was to require employers to provide coverage. Conservative economists frowned on that, because they said it distorted the labor market. But having everyone covered did remain a key goal. Why? Danzon says it's neither a liberal nor a conservative thing, but purely an economic one.

DANZON: The truth is that we're not so mean-spirited that we deny people health care when they truly need it. And so people who don't have insurance, in fact, do get coverage if they desperately need it in an emergency situation, and that ends up being a burden on everybody else. And it's not the most efficient way to provide health care for them.

ROVNER: In other words, making individuals responsible for their own health care is preferable to socializing the health care system. Or, as Romney put it in an interview on MSNBC just last week...


ROMNEY: Personal responsibility is more conservative, in my view, than something being given out for free by government.

ROVNER: Romney, once again, made the case in that interview for why requiring individuals to have health insurance was - and is - a conservative idea. But now that it's been embraced by President Obama and proved unpopular with voters, don't expect to see Republican presidential candidates doing much beyond just saying no.

Julie Rovner, NPR News, Washington.

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