PolitiFact: Hillary Clinton did oppose individual mandate back in ‘93

Says Hillary Clinton opposed an individual mandate and favored an employer mandate back in 1993.

Gov. Bobby Jindal, R-La., in an op-ed May 13 for Politico Magazine

Louisiana Republican Gov. Bobby Jindal still thinks the Affordable Care Act is unworkable, and he found an unlikely ally to help him criticize the law: Hillary Clinton.

But there’s an important twist: Jindal was quoting Clinton from 1993.

In an op-ed for Politico, Jindal rehashed his opposition to the individual mandate that requires most Americans to buy health insurance, a key tenet of President Barack Obama’s health care law. And he noted that Clinton once opposed it, too.

“It is a well-known fact that Clinton came to strenuously support an individual health insurance mandate in her 2008 primary campaign against Barack Obama,” Jindal wrote. “Less well-remembered, however, is that Clinton considered an employer mandate — not an individual mandate — the best way to achieve ‘universal coverage’ in her health care task force’s ill-fated 1993 proposal, put forth while she was first lady.”

Twenty years have passed since the Clinton administration’s unsuccessful attempt at a health care overhaul, but hey, we live in the days when hologram Michael Jackson performs on stage. So maybe what’s old is new again.

In 1993, Hillary Clinton led a task force created by her husband, President Bill Clinton, with the goal of overhauling the health industry and providing care for most of the population.

On Sept. 22, 1993, President Clinton laid out his proposal based off the task force’s findings. Universal coverage, he said, could be achieved by requiring all employers to provide insurance to workers.

First lady Clinton then testified on the Hill for several days to explain and defend the plan before a handful of congressional committees. Clinton said the administration settled on an employer mandate, rather than instituting a broad-based tax similar to Medicare, or an individual mandate, which a handful of Republicans had offered as a means of achieving universal coverage.

We reviewed hours of Clinton’s testimony and many news accounts from 1993. We can say with confidence that Jindal is right: Clinton opposed delivering universal coverage entirely through an individual mandate and supported an employer mandate.

But Jindal also picks out a couple of Clinton’s concerns and tries to tie them to current events, as though her comments in 1993 foreshadowed Obamacare’s impact on the health care industry. Perhaps Clinton’s misgivings are relevant to today’s debate, but not how Jindal portrayed them.

For example, as Jindal notes, Clinton testified she thought employers may see the individual mandate as an opportunity to forgo providing their employees insurance and push them instead to the new individual market.

Jindal tries to link this comment to the millions of individuals who had their policies canceled last year due to minimum requirements in Obamacare (which, he notes, contributed to PolitiFact’s Lie of the Year). Clinton’s concerns, though, have nothing to do with what happened to those people. The millions who had their policies canceled or changed last year bought plans from an independent provider, not through their employer.

Clinton also thought employers might feel pressure under an individual mandate to keep wages low so employees would qualify for government subsidies to buy insurance on the private market. Jindal wrote, “That sounds a lot like what the Congressional Budget Office concluded in February: that Obamacare will reduce the labor force by the equivalent of 2.3 million workers, because employers will not raise wages and individuals will choose not to work in order to retain access to government insurance subsidies.”

That’s not exactly what the CBO said. People aren’t leaving jobs to make themselves eligible for subsidies. Rather, the CBO said affordable insurance would make it possible for individuals to voluntarily cut back hours or quit jobs they stayed in only for the health insurance.

It’s worth noting, too, those weren’t Clinton’s only concerns. She also said the existing system was heavily reliant on employer-provided coverage and an employer mandate would be the “least disruptive” and most familiar to people.

Over the past two decades, though, fewer individuals are receiving health care benefits from their employer. It’s still a plurality of Americans, but it has dropped steadily. In 1997, nearly 65 percent of individuals bought their insurance through their employer; in 2010 it was 56.5 percent, the U.S. Census said.

Clinton also had “great concerns about how the administrative structure to track the individual contribution, to collect it and to then connect it with health insurance would be set up.” Such a system, she said, would be “extremely complicated and bureaucratic.”

The technology the Obama administration used (eventually) to create a new market for buying and selling private health insurance is inconceivable to anything Clinton could have imagined back when the World Wide Web was an infant. That may have assuaged some of her concerns about the logistical hurdles. Though, as Obama can attest, even with the technology, it hasn’t been easy.

Finally, we noticed Clinton wasn’t all that down on the individual mandate, an idea promoted by moderate Republicans. She said it was “in the same ballpark” as her plan. It just wasn’t her preferred pathway.