Lamar Alexander’s Campaign Coy on His Past Support, Future Plans for Insurance-Coverage Mandate

Should the GOP take control of Congress’s upper chamber in November, Lamar Alexander will become — if he wins re-election — chairman of the U.S. Senate Health, Education Labor and Pensions Committee.

Among the key issues he wants to tackle is a top-to-bottom revamp of the Patient Protection and Affordable Care Act, which was signed into law in 2010 without having earned a single Republican vote in Congress, when Democrats controlled both houses.

Alexander, currently the ranking Republican on the HELP Committee, was among 15 national “health care thinkers” that Politico asked last month to contribute views on what to do about the ACA “for the long haul.” His prescription, which appeared under the heading, “A conservative alternative,” included a declaration that “Obamacare is so flawed that it cannot be fixed.”

“Instead of tinkering at the edges of this historic mistake, we need to move as rapidly and responsibly as we can in an entirely different direction,” wrote the former Tennessee governor. “We need to transform our health-care delivery system into one that emphasizes freedom and choice and lower costs.”

Some of his other ideas included allowing Americans to return to their previous insurance plans if they want, expanding the use of high-deductible policies and health-savings accounts, allowing health insurance to be sold over state lines, and enabling small businesses to pool resources to buy lower-cost health insurance plans.

“Republicans are ready to repair the damage of Obamacare, prevent future damage and transform our health-care delivery system step by step,” Alexander wrote.

Alexander’s piece did not mention, however, any plan for the so-called individual mandate under the Affordable Care Act, a provision of the current law that requires all Americans to prove they’ve purchased government-approved health insurance, or face tax penalties that the Internal Revenue Service will enforce.

In multiple email correspondences and phone conversations with Alexander’s campaign over the past week, TNReport asked for clarification from the two-term incumbent as to whether he’s committed to eliminating any federal requirement that people carry medical coverage. A spokesman for Alexander did not directly answer the question, but instead pointed to the Tennessee senator’s numerous votes to repeal the ACA since it was enacted, although no attempt to repeal the law has ever passed the Senate.

Also unaddressed in TNReport’s communications with the campaign were requests for Alexander to explain what led to his apparent change of heart on the issue.

Prior to passage of the Affordable Care Act, Alexander supported legislation that included a federal mandate that people buy health insurance.

In 2007, when George W. Bush was president, Alexander co-sponsored a bipartisan health care reform bill, the Healthy Americans Act. The proposal required citizens to carry a minimum level of health insurance. It also established subsidies for buying insurance, and ended tax-free employer-provided coverage.

Flash forward two years, when outraged Tea Party protesters across the country boisterously confronted lawmakers at town-hall meetings and voiced opposition to the Affordable Care Act.

In an August 2009 Washington Post op-ed, the Healthy Americans Act’s sponsors and co-sponsors argued that their legislation showed Republicans and Democrats could find “common ground,” and move efforts to reform the American health care system forward with bipartisan support. Republican co-sponsors of the bill “agreed to require all individuals to have coverage and to provide subsidies where necessary to ensure that everyone can afford it,” wrote the op-ed’s authors, a group that included Alexander.

Conceived in the late 1980s by the Heritage Foundation, a conservative Washington, D.C.-based think tank, Republicans like former Speaker of the House Newt Gingrich and former Presidential Nominee Mitt Romney favored the idea of mandating that Americans buy medical coverage. As governor of Massachusetts in 2006, Romney famously enacted a health-care law that included a coverage mandate. Liberals, including President Obama, were initially critics of requiring people to obtain health insurance, and only later embraced the mandate as they sought, if unsuccessfully, GOP support for their health-system overhaul.

When the U.S. Supreme Court delivered its split decision in 2012 upholding the individual mandate’s constitutionality, Alexander released a statement calling on Congress to repeal Obamacare in its entirety and “then proceed step by step to reduce the cost of health care so more Americans can afford to buy insurance.” He did not mention then whether or not mandating that Americans carry insurance should be one of those steps, although in 2013 Alexander co-sponsored legislation with Utah Republican Orrin Hatch to specifically do away with the individual mandate. The American Liberty Restoration Act stalled in committee.

Alexander’s opponent in the general election next month, Gordon Ball, a Democrat who has portrayed himself as a politically “hybrid” candidate, said although he likes parts of Obamacare he “vigorously opposes” other sections of the law.

“Several things I do like include ending discrimination for pre-existing conditions, tax breaks for small businesses and allowing younger people to stay on their parents’ insurance until they are 26,” Ball said in an email from campaign spokeswoman Trace Sharp. Ball’s campaign declined to elaborate further in email on what he finds lacking with the law, although his website criticizes the law’s length and IRS enforcement of the mandate.

Alexander has yet to agree to Ball’s requests to a public debate.