Hillary Clintons Quote on Health Mandate Misunderstood

In the nearly 4,000 pages of Clinton White House documents released last month, a comment from then-First Lady Hillary Clinton received a wave of attention.

In a speech to congressional Democrats in 1993, it sounded like she was dissing the requirement that all Americans have health insurance. The full set of facts is more complicated.

That policy, of course, later became the centerpiece of her own health-care plan as a presidential candidate in 2008 and, later still, of President Barack Obamas health law.

In 1993, she spoke critically of the leading Republican alternative to the Clinton health plan. The GOP plan relied heavily on an individual mandate; by contrast, the Clinton plan rested on a requirement that all employers offer insurance and pay the bulk of the premium.

Mrs. Clinton first said the GOP proposal would be a much harder sell than the Clinton plan. Then, she said: Not only will you be saying that the individual bears the full responsibility, you will be sending shock waves through the currently insured population that if there is no requirement that employers continue to insure, then they, too, may bear the individual responsibility, Mrs. Clinton said.

But some in Clinton quarters say that this quote has been wrongly interpreted as suggesting it was the individual mandate itself that she didnt like.

People have misunderstood the context of the quote, said Neera Tanden, a health-care expert who was the top policy adviser to in her 2008 campaign and is now president of the Center for American Progress.

At the time, Mrs. Clinton was not opposed to the individual mandate, Ms. Tanden said. In fact, the Clinton plan itself included a requirement that all individuals have health insurance, though it was a minor part of plan because it relied more heavily on the employer mandate.

The Republican plan, by contrast, relied chiefly on the individual mandate. It required employers to offer coverage, but unlike the Clinton plan, did not require businesses to pay anything toward premiums. The plan also limited the tax break companies now get for offering insurance.

At the time, the White House was worried that these provisions would lead employers to drop coverage. A 1993 White House analysis of the GOP bill said: Under the Republican Health Task Force plan, individuals would be required by law to buy insurance. While employers would still be free to contribute for insurance coverage, they would have no responsibility to do so. That means that middle-class families will bear the full cost of their insurance, if employers choose not to help pay for health coverage.

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Hillary Clintons Quote on Health Mandate Misunderstood

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