Steve Benen points out that Jon Huntsman’s willingness to lie about his past support for the individual health insurance mandate undermines his “veracity as a candidate.” Several weeks ago, Huntsman was telling reporters that he “did not back a mandate as part of his reform package in Utah,” but this video from September 28, 2007 says otherwise:

HUNTSMAN: I’m comfortable with a requirement [to have coverage]. You can call it what you want, but at some point, we’re going to have to get serious about how we deal with this issue. And that means there will have to be a multitude of different policies that are available in the market place. It means that it will be incumbent upon citizens to look at responsibility, their own responsibility in terms of health and the choices that are made…. There is a mandate today, let’s not forget, it’s called the emergency room…. We’re living today in an environment, to be sure, where there’s a mandate in place. It’s whether you really want to make the system more efficient.”

Watch it:

Huntsman is of course in good company. He joins Mitt Romney, Newt Gingrich, and possibly Tim Pawlenty as a potential GOP candidate who was for encouraging individuals to take personal responsibility for their health care before he was against it.

The Los Angeles Times’ Noam Levey looks at the history of the individual health insurance mandate and discovers that not only was the provision designed by Republicans as an alternative to President Bill Clinton’s health care reform plan in the 1990s, but it was specifically seen as a way to prevent a “government takeover” of health care:

“We were thinking, if you wanted to achieve universal coverage, what was the way to do it if you didn’t do single payer?” said Paul Feldstein, a health economist at UC Irvine, who co-wrote the 1991 plan with Pauly.

Feldstein and Pauly compared mandatory health insurance to requirements to pay for Social Security, auto insurance, or workers’ compensation.

So too did the Heritage Foundation’s Stuart Butler, who in 1989 wrote a health plan that also included an insurance requirement.

“If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate, but society feels no obligation to repair his car,” Butler told a Tennessee health conference that year.

“But healthcare is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance.… A mandate on individuals recognizes this implicit contract,” said Butler, who was the foundation’s director of domestic policy studies.

Levey notes that fully a third of Republicans supported a bill that included a national individual requirement, introduced by then-Senator and current Rhode Island Gov. Lincoln Chafee. Sens. Bob Dole (R-KS), Charles Grassley (R-IA), Orrin Hatch (R-UT), and Richard Lugar (R-IN) all backed that measure. The National Federation of Independent Business, a conservative small-business group, even “praised the bill ‘for its emphasis on individual responsibility.’”

And this wasn’t some fluke of the ’90s either. As recently as 2007, “[t]en Republican senators — including Tennessee’s Lamar Alexander, now a GOP leader — signed on to a bill that year by Bennett and Sen. Ron Wyden (D-Ore.) to achieve universal health coverage.” The legislation penalized individuals who did not purchase insurance coverage.

Listing all of the GOP presidential candidates who have previously supported the mandate (Romney, Gingrich, Huntsman, Pawlenty) would only belabor the point, which is that the GOP’s new-found religion on the mandate and its constitutionality is driven by the political need to unravel the Democrats’ crowning social achievement, not any great concerns about policy, constitutionality, or freedom.

Our guest blogger is Jorge Madrid, a research associate for the Energy Policy Team at the Center for American Progress Action Fund.

The Center for American Progress Action Fund is leading a campaign to curb asthma and other harmful health effects from coal-fired power plants. This campaign is already underway and it will continue until July 2, 2011.

Asthma affects all Americans. But communities of color are particularly vulnerable to respiratory diseases such as asthma. A recent report by the Centers for Disease Control and Prevention shows that African American children have the highest number of asthma attacks among all ethnic groups, and Latino children are 60 percent more likely to suffer from asthma attacks than white children. Likewise, more than 71 percent of African Americans and 66 percent of Latinos live in areas that fail to meet one or more of the Environmental Protection Agency’s air quality standards.

These crippling health disparities are made worse by the fact that communities of color are the least likely to have health insurance and access to treatment and preventive care.

Higher asthma rates also mean more missed days of work and school in addition to increased medical costs. Every day in America, 40,000 people miss school or work due to asthma, and 5,000 people visit the emergency room due to the disease.

Asthma is triggered by dirty air, and asthma rates are higher in places with bad air quality. Exhaust from cars, factory emissions, smoke, and dust cause poor air quality, which can aggravate the lungs and worsen chronic lung diseases, according to the Environmental Protection Agency (EPA).

Coal-fired power plants are also a big part of the problem. Power plant pollutants are a well-known trigger, as is smog. Asthma has no known cure, but it can be controlled by limiting exposure to these triggers.

The EPA is responsible for protecting our children and families from dangerous pollutants and toxins. They have a proven track record of reducing deaths and illness due to stronger clean air standards.

The EPA took a critical step toward cleaner air on March 16, 2011, by proposing its first-ever air toxics standards for coal-fired power plants. The proposed rule would limit emissions of mercury, arsenic, and other air toxics from power plants for the first time. Adoption of the air toxics rule will prevent approximately 17,000 premature deaths, 120,000 asthma attacks, and 12,000 hospitalizations and emergency room visits every year in 2016, according to the EPA.

All Americans should make a strong statement to the EPA that they want reductions in mercury, arsenic, and other toxic air pollution from power plants. Communities of color in particular can send a message that they want clean, healthy air for their children and families.

USA Today’s Kelly Kennedy is reporting that as health care premiums continue to outpace wages, a growing number of Americans are now turning to high-deductible coverage for premium relief:

In 2007, about 4.5 million people had high-deductible plans, but by 2010, 10 million people had signed up for the plans, according to an America’s Health Insurance Plans survey of its members.

In exchange for a high deductible — a maximum $3,000 deductible for individuals and a $6,000 deductible for families, for instance — people can save about $85 to $100 a month on premiums.

“People are choosing higher deductibles for lower premiums,” said Karen Ignagni, president of America’s Health Insurance Plans, which represents 1,300 companies providing health insurance to more than 200 million Americans.

It’s important that they understand those lower premiums can mean higher doctors’ bills, she said.

Families spend thousands to meet their deductible and often times avoid treatment altogether. And it’s not the kind of high-tech super expensive care that people are abusing. What the research shows is that people are forging preventive care — the very services that help avoid high costs in the future:

RAND researchers also found that people on high-deductible plans — no matter their income level — received less preventive care: fewer annual exams, fewer cervical cancer screenings and fewer colonoscopies.

Studies have shown that people don’t know that their plans waive fees for preventive care, researcher Amelia Haviland wrote in the report.

According to the study, families enrolled in high-deductible coverage spent 14 percent less in the first year than families with lower deductibles, but “the percentage of young children receiving vaccinations dropped as much as 8.5 percent in the first year their families were covered by the high-deductible plans, while vaccination rates for children in standard plans rose slightly.” “And use of cancer screenings was two to three percentage points lower among families with high deductibles.”

The other problem is that catastrophic-only plans generally appeal to a younger and healthier population that doesn’t think it will ever get sick — at least not in the immediate future. They opt for these kinds of plans, thus further fragmenting the health care market.

The Affordable Care Act already gives younger individuals the option of enrolling in high deductible plans that cover less services at cheaper rates. Insurers will also be able to price their policies based on age and charge young people rates that are three-times lower than what older (and presumably sicker) applicants will be paying.

But some conservatives want to seize the growth in catastrophic-only coverage and go even further. They’re suggesting that insurers should be allowed to design catastrophic plans outside of the requirements of the law (which mandates policies to provide a set of essential benefits) and the exchanges. You can see how this wouldn’t work. If younger people have an incentive to enroll in cheaper high-deductible coverage, the exchanges will be left with sicker individuals who need comprehensive coverage and use it frequently. Without healthy individuals to offset the costs of this care, premiums will have to increase, pushing out everyone but the sickest and neediest applicants. As a result, the exchanges will become cost prohibitive for most Americans.

Over on Ezra Klein’s blog, Austin Frakt of the indispensable Incidental Economist argues that after comparing Rep. Paul Ryan’s (R-WI) Medicare plan to Medicare Part D and the Federal Employees Health Benefits Program (FEHBP), Republicans finally stumbled upon an analogy that actually works: employer-sponsored health insurance. The quote came from Rep. Eric Cantor (R-VA) speaking Sunday on CBS’s Face The Nation:

HARRY SMITH (overlapping): But the– but the question becomes, is it– is the voucher the answer? Is that the only answer? Because, if I understand it correctly, I get a voucher and then I have to go out on the marketplace and hope I’m going to get the insurance I need. And if that’s the– that’s the case, you’re talking about medical rationing. You’re talking about going to insurance companies to– to get what you hope you– you deserve.

REPRESENTATIVE ERIC CANTOR: Well, Harry, I’m– the– the– the reforms that we put forward would apply to everyone fifty-four and younger. And again, what it does is it reforms the program to ensure its still there. And it is much like what most people have with their employer plans. That they are by the employer given the benefit but then choose from a variety of plans out there that best fit their family’s needs. So it’s an attempt to try and personalize the– the Medicare program to allow seniors to choose much like they have with the Medicare Part D program–

As Frakt points out, Cantor is right in the sense that like Ryan’s premium support vouchers, the employee contribution to health care has “increased much faster than inflation or wages.” “[P]remiums are consuming a larger portion of workers’ resources. For many, they’re becoming unaffordable. That’s exactly what will happen to beneficiaries under the Republican plan for Medicare,” he writes.

All this is true, but I would also argue that employees are currently much better off than seniors who become eligible for Ryan’s vouchers. Even as their share is increasing, employees aren’t going up against insurers all by themselves. They’re part of a group health care plan which — if the employer is large enough — can help defray increases, spread risk and cost, and shield the policy holder from other insidious practices that insurers often deploy against the individual consumer.

Rep. Paul Ryan (R-WI) does deserve some credit for responding to Ezra Klein’s questions about his plan — even if only through email — but as someone who attended eight of his town halls in Wisconsin, I can say that his staff did not spend too much time thinking about the answers. They simply molded his typical responses to fit Klein’s questions. That being said, it’s not surprising that there is so much to debunk in his replies. Klein and Jonathan Chait get at some of Ryan’s inaccuracies, so I will contain my response to question 5, in which Ryan tries to argue that his plan would not shift costs to seniors because some of them would receive a higher voucher:

5) The Congressional Budget Office says that private insurance will be more expensive than traditional Medicare insurance of the same quality, and under that analysis, your plan saves money by shifting costs. What happens if they’re right? Would you support your plan if, in 10 years, the savings proved to be primarily achieved through shifting costs to seniors?

Our reforms do not shift costs, they bring down costs. As I explained in a recent interview:

“A couple of things on that analysis. Number one, it fails to take into consideration the extra $7,800 — we’re talking about adding to low income seniors’ benefits. What we’re saying is protect those who are low income by supplementing their benefits and covering their out of pocket costs. We’re also saying as people get sicker, increase their payments to stabilize their premiums and as people get wealthier don’t subsidize them as much. It is really inaccurate to suggest that’s going to happen to everyone.

“The other thing I would say is its comparing Medicare to a fiscal fantasy, which the current system is unsustainable and it is growing at rates that are unsustainable that will crash the system. The question is: what are the kinds of reforms we are putting in place to get at the root cause of health inflation, to make our health care dollar stretch farther, to inject competition into the system so we can stretch our dollar farther. And then subsidize people more who need it more and not those who need it less.

“It is really an incomplete comparison to suggest that’s happening to everybody. Yes, wealthier people are going to pay more in the future, but more importantly there is only so much money to go around – it is finite. What we believe we should do is save Medicare so it is something the next generation can count on and subsidize people who need it the most and not as much as people who need it the least.”

The CBO analysis of Ryan’s proposal found that a “typical” 65-year old would be paying more under Ryan’s plan, regardless of income. “[A] typical beneficiary would spend more for health care…[because] private plans would cost more than traditional Medicare,” the budget office concluded. “[T]he government’s contribution would grow more slowly than health care costs, leaving more for beneficiaries to pay.”

In fact, lower-income seniors — so-called dual eligibles who qualify for both Medicare and Medicaid — would also be harder hit (despite the additional government assistance). As the Center on Budget and Policy Priorities (CBPP) points out, the Ryan budget plan would eliminate the supplemental Medicaid coverage low income seniors receive and instead give this group — which often suffers from multiple chronic conditions — a medical savings account in the amount of $7,800. That amount would grow with inflation every year and would “fall short of what is needed to cover their expenses.” “The savings account amount would cover only 62 percent of the typical 65-year-old’s out-of-pocket expenses in 2022; this beneficiary would still have to pay an additional $4,700 in health care expenses,” CBPP concluded. “This would consume 34 percent of the income of a Medicare beneficiary living at the poverty line (an estimated $13,620 for an individual in 2022). “

With Mitt Romney set to announce his candidacy later this week, the Boston Globe’s Brian C. Mooney is publishing a series about Massachusetts’ groundbreaking health care reform law. This first piece explains how the idea was hatched — Romney was inspired by Staples founder Thomas G. Stemberg — made its way through the Democratically controlled legislature, was embraced by business groups, and eventually signed into law by Romney on April 12, 2006.

Mooney reports that Romney’s political advisers weren’t too keen on Romney — who was even then expected to just serve one term as governor before making a run for the presidency — embracing a traditionally liberal issue, but ultimately settled on what they and Romney saw as a fairly conservative approach: encouraging individuals to take personal responsibility for their health care costs by buying insurance coverage through exchanges:

The first step was finding a way to make the 37 percent who could afford insurance but didn’t have it buy in. Romney’s answer came in part from an administration consultant, Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology and a leading adviser, usually to Democrats, on health care reform issues….“What my numbers showed is that it made enormous sense to have the individual mandate,’’ Gruber recalled. Without it, the money available for new insurance subsidies would cover half as many people.

“Romney was intrigued with it because of the personal responsibility aspects,’’ said Gruber, recalling his one meeting with the governor. And if younger, healthier people were coaxed into the system, the cost of premiums would moderate for a larger population.

“There was the moral ‘free rider’ argument, but the numbers said it was financially feasible, too,’’ Gruber said.
[...]

There were other new elements. Murphy had a “eureka moment’’ after a meeting with officials of the conservative Heritage Foundation. He was raving about their concept of an “exchange’’ to provide one-stop shopping for small businesses and individuals seeking health coverage from commercial insurers. This would also prove a forerunner to Obama’s national plan.

Today, conservatives see these ideas as unconstitutional conspiracies to usurp individual freedoms, but back in 2005, America’s greatest liberal Senator needed some convincing. In fact, up to that point, the late Ted Kennedy had opposed the mandate and only came to support the provision as part of a larger reform package. “I’ve never been one for individual mandates in the past, but I do think that the way this has been proposed, in that everybody will do their part, that’s a compromise,’’ Kennedy said in December 2005. “I can buy into that.” (Incidentally, current Massachusetts Governor Deval Patrick experienced a similar conversion).

Kennedy bought it and so did Romney, who came to see the mandate as the “ultimate conservative” solution. “It’s the ultimate conservative idea, which is that people have responsibility for their own care, and they don’t look to government to take of them if they can afford to take care of themselves,” he told the Boston Globe in June 2005. “I think it appeals to people on both sides of the aisle: insurance for everyone without a tax increase.” He even went so far as to suggest that it can be applied to the nation as a whole — although he quickly walked back these statements and proposed an altogether different health care proposal during his 2008 presidential campaign.

Mooney’s whole piece is worth reading, if only to remember just how distorted the political health care rhetoric has become.

Mitt Romney trotted out that old argument about the Affordable Care Act being too long when trying to explain the differences between Massachusetts health reform and Obama’s law on NBC’s Today Show:

ROMNEY: I understand there are a lot of people who would like me to get up and say it was a terrible, boneheaded idea, it was a terrible mistake and we are all entitled to mistakes. The only problem is it wouldn’t be honest. we solved a serious need that existed in our state.

Q: President Obama can’t wrap his arms around you tightly enough. He said RomneyCare inspired ObamaCare.

ROMNEY: If I become president, I will repeal ObamaCare. My bill was 70 pages. His is over 2,000. He’s doing a lot of stuff that’s devastating to the health care system in this country. He’s wrong.

Watch it:

Despite the disparity in length, the two laws are very similar in how they try to expand access to health care and some of those extra pages in the ACA are devoted to controlling health care spending — something Romney didn’t include in his 2006 law:

Republicans appeared on the Sunday morning political talk shows with a unified message: lawmakers can either pass the GOP budget or they can opt to do what the Democrats are proposing, which is nothing at all, allowing the program to go bankrupt and the deficit to skyrocket. During an interview with Sen. Chuck Schumer (D-NY), Meet The Press host David Gregory bought into this canard by asking, “Is there a danger for Democrats in not seriously engaging on Medicare as being seen as abdicating responsibility on really fighting the deficit writ large?”

Schumer’s response — which emphasized that Democrats already seriously engaged on Medicare by extending the solvency of the program in the Affordable Care Act and that Republicans would literally end traditional Medicare as an option to seniors — should serve as a guide to any Democrats who are asked to respond to that kind premise:

SCHUMER: The bottom line is very simple. We already proved our bona fides in last year’s bill, where we, where we extended Medicare’s life by 12 years by doing some of the things that I talked about there on delivery system reform. And we’re going to continue to do that. There’s a choice here–there are three choices. One is to do nothing. One is to preserve the benefits but change the delivery systems and not let some of the providers, like the drug companies, get away with so much. And one is to end Medicare as we know it. Democrats are in the second one, Republicans are on the third one. Until Mitch McConnell abandons the third one, we are not going to get a budget deficit agreement. It’s that simple. [...]

The difference is between us and Republicans. They want to end Medicare as we know it. If you turn it over to a pure system where the–where the insurance companies govern, here’s what happens according to CBO, nonpartisan: the beneficiaries, instead of paying 25 percent, pay 68 percent. But at the same time, the costs don’t go down, they continue to rise because the insurance companies pass the costs to the beneficiaries. That is wrong. That is not politics, I would say to my dear friend Senator McConnell. That is what America’s all about. And we will, we will oppose them in the budget negotiations if they don’t abandon Ryan, and it will legitimately be one of the major issues of the election year in 2012.

Watch it:

One could go even further and argue that, while health care costs are in fact out of control, the possibility of Medicare going bankrupt is — and historically has been — greatly exaggerated. In fact, if no changes are made, Medicare would still be able to meet 88 percent of its obligations in 2085. But the “time bomb” argument is now being used by opportunistic opponents of the program — the same party that at one point argued that it should whither on the vine — to end it and transfer future enrollees into the hands of private insurers that have historically done a worse job of controlling health care spending and charge more for similar benefits.

It’s also worth pointing out that as Republicans — particularly the contenders for the presidential nomination — grow weary of the public rejection of the Ryan plan and begin forming their own, more moderate proposals, they’ll be offering the very same kind of delivery system reforms that Schumer is describing as choice two. (Only they would want to repeal them first).

I’m excited to welcome you to the new ThinkProgress and ThinkProgress Health, a brand new blog focusing on the politics and policy of health care and health reform.

ThinkProgress Health will focus on unraveling the latest conservative attacks against health reform, cover all of health care battles in Congress, and provide exclusive on-the-ground coverage from all of the the 2012 presidential candidates as we enter the primary season.

But the central devotion to health topics will also allow us to solicit contributions from our health policy team at the Center for American Progress and health wonks from around the country to provide more in-depth analysis of the emerging health care proposals from the presidential hopefuls and the ongoing effort to implement health care reform by the federal government and the states. TP Health will also feature integrated content from the new ThinkProgress site and Matt Yglesias.

So bookmark us — http://health.thinkprogress.org — add us to your RSS readers –- http://thinkprogress.org/health/issue/feed/ –- follow us on Twitter –- @TPHealth — and contact me with your ideas and suggestions. I’m very excited about all the health news ahead and look forward to hearing your feedback and comments!

– Igor Volsky
Editor of ThinkProgress Health