Ed Gillespie’s 2006 book "promoted an individual health care mandate, and recommends that it be enforced by the IRS through the income tax code."
Republican Senate candidate Ed Gillespie rarely leaves a microphone without criticizing Democrat incumbent Mark Warner’s 2009 vote for Obamacare. The Democratic Party of Virginia says the attacks are hypocritical, maintaining that Gillespie once embraced a policy that is at the heart of President Barack Obama’s health reform law -- an individual mandate that most Americans have insurance or pay a penalty. "Gillespie’s memoir promotes an individual health care mandate, and recommends that it be enforced by the IRS through the income tax code," the party stated in a March 24 news release. The Democrats were pointing to words that Gillespie -- a former White House adviser and chairman of the Republican National Committee -- wrote in his 2006 book, "Winning Right: Campaign politics and conservative policies." We wondered if Gillespie’s memoir really did promote an individual mandate for health insurance -- the bane of many conservatives who oppose Obamacare. Under the Affordable Care Act, also known as Obamacare, Americans without health coverage start paying a penalty this year. By 2016, the levy grows to $2,085 per family or 2.5 percent of household income -- whichever is greater. Certain tax filers facing financial hardship and other situations are exempt. Paul Logan, Gillespie’s campaign spokesman, told us in an e-mail that "Ed never supported the individual mandate." Gillespie made a similar statement to the Washington Examiner last December, before he announced his candidacy. "If I run against Sen. Warner, my critique of Obamacare will be consistent with my past positions in opposition to an individual mandate and too much government intrusion in our health care sector," he said. But Democrats point to a 2006 book passage in which Gillespie wrote that health care reforms should ensure that uncovered adults gain health care insurance so they won’t remain "free riders" who get care at others’ expense. "A more rational approach is to ensure that every emancipated adult capable of providing for his or her health care do so," Gillespie wrote. "One way to accomplish this is to use the tax code to gain compliance. Annual filers would have to attest that they have some form of health coverage or else the ‘standard deduction’ on their income tax would be cut in half." Right after this passage, Gillespie discussed another way to ensure all adults provide for their own health care. "Another approach would be the creation of tax-free Health Savings Accounts that would be refunded after a certain period for any use," he wrote. "If after seven years, an individual didn’t use his HSA funds for health care, the money would be treated like an income tax refund. The inducement of tax-free savings for those who are healthy would provide an incentive for more people to obtain insurance coverage.". We twice asked Gillespie’s campaign why his suggestion to cut the standard deduction for uninsured people should not be considered support for a mandate. Logan did not provide a direct answer, saying Gillespie was writing about "various proposals for reforming health care under consideration at the time." Logan also pointed us to an op-ed earlier this month in Forbes in which Merrill Matthews, a resident scholar at the conservative Institute for Policy Innovation, said the passage In Gillespie’s book amounts to an "anti-mandate approach." Matthews told us he "assumed" that Gillespie, in his 2006 book, was endorsing an unsuccessful proposal President George W. Bush made one year later offering tax breaks to insured households. Bush’s "carrot" approach sought voluntary compliance; it did not mandate the purchase of health insurance, but would have rewarded most people who had coverage. That’s different from Obama’s "stick" approach of insisting people obtain coverage or face tax penalties. But Matthews added that the Gillespie campaign has never told him his assumption is correct and that Gillespie’s language in the book is unclear. Logan also pointed to a column from the conservative National Review magazine which said "some of the language (‘ensure,’ compliance’) sounds pro-mandate, but the actual policies described strongly resemble the proposals of the Bush administration and of Paul Ryan, which very few conservatives have described as the equivalent of a mandate." We spoke to two health care experts who had a different take on Gillespie’s prose. Ted Marmor, a professor of health policy at Yale University, told us the policy Gillespie described is "the functional equivalent of an individual mandate without using the words mandate and fine." "Absolutely, that’s an individual mandate," said Michael Tanner, a senior fellow at the Libertarian Cato Institute, after reading Gillespie’s passage. Tanner said the passage sounds like an endorsement Massachusetts health care reforms that then-Gov. Mitt Romney, a Republican, signed a few months before Gillespie’s book was published. The law imposed tax penalties on state residents who could afford insurance and refused to buy it. In November 2006, a few months after his book was released, Gillespie specifically weighed in on the Massachusetts plan. "You see Mitt Romney in Massachusetts is taking some steps toward individual requirements for people to carry their own insurance. I think the party is probably open to that kind of approach," Gillespie told C-SPAN. "Others are proposing small business health plans and greater transparency and putting the consumer closer in touch with the health care expenditure. I think that’s a good direction." Logan, Gillespie’s spokesman, said the interview establishes his boss’s mindset: While Gillespie opined that the GOP might be open to an individual mandate, Gillespie added he personally thought a "good direction" was to pursue a different approach. In ensuing years, Gillespie emerged as a steadfast opponent to the individual mandate in Obamacare. In November 2009, he told ABC News that the health reform bill under consideration was a "monstrosity" in part because of "the mandates in it." As our colleagues at PolitiFact National have reported, the individual mandate was discussed in Republican circles more than 15 years before Obamacare even existed. In 1993 some Republican senators signed onto a bill that would have required everyone to buy insurance. The legislation was an alternative to then President Bill Clinton’s failed health care reform plan that required employers to pay for insurance and then closely regulated insurers and health care providers. Our ruling Democrats said Gillespie’s book "promoted an individual mandate." Gillespie’s 2006 memoir states that one way of reforming health care is to require people to carry insurance or have their standard tax deduction cut in half. That fits the definition of an individual mandate. Gillespie’s campaign denies this is the case, but declines to provide a clear explanation. It should be noted that Gillespie offered tax consequences as one possibility for reforming health care. His book suggested Health Savings Account as another way to ensure adults get coverage. Webster’s New World College Dictionary defines "promote" as "to help bring about" something. Although it may not have been Gillespie’s intention, his unclear book passage can be easily interpreted as advancing the idea of individual mandates during a formative time for health policy. So we rate the Democrats’ claim Mostly True.
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