Q:  What are the precedents for mandated health care insurance, if any? What would the Founding Fathers have thought of the idea?

A:  Yes, a law passed in 1798 and signed into law by President John Adams, one of the nations Founding Father.

Most people have heard that Mitt Romney was responsible for a health care law when he was Governor of Massachusetts that included an individual mandate very similar to the one included in the Affordable Care Act (“ACA”).  It is widely recognized that the Massachusetts plan was a model for the ACA, although today Romney would say that his plan was right for Massachusetts, but never intended it to be a model for a federal plan.  An Op Ed piece Romney wrote in 2009 has made this claim by Romney somewhat debatable. Also read this.

So is there a precedent for individuals being forced or mandated to by health insurance at the federal level?  It turns out that there is such a law, “An act for the relief of sick and disabled seamen” that created a government run health care system and series of government run hospitals for seaman involved in commerce, and mandated that all individuals pay for health insurance via a payroll tax, the first of its kind.  An excellent article by Rick Ungar, writing in Forbes Magazine, documents this law and its applicability to today’s situation.

If you have never heard of this law it is probably because it was passed in 1798 soon after the nation was founded. Thomas Jefferson was the President of the Senate at the time, and the Speaker of the House was Jonathan Dayton, the youngest man to sign the United States Constitution.  The President who signed the bill into law was John Adams.  There would seem to be little doubt that these men understood the thoughts of the founding fathers and the limits of the Constitution as they WERE the Founding Fathers and WROTE the Constitution. 

The conservative blogosphere has reacted to the Forbes article pointing out that the purpose of the disabled seamen act was not to promote general welfare or the heath of U.S. citizens, but rather for the purposes of national security and preservation of international trade. They also mention that the act did not require individuals to purchase any product, like the ACA does, but rather funded the program via a payroll tax. Legally, they may have a point, but the disabled seamen act makes it hard to argue that the founding fathers would have opposed the establishment of a health care system that had mandated funding.  And if conservatives would agree that funding of a healthcare program for all via a payroll tax is acceptable, liberals would, no doubt, support an immediate repeal of the ACA and replace it with a “Medicare for All” program.  If you are looking for a precedent for a mandated health system with mandated payments, one needs to look no further than Medicare.  If the Medicare is OK for those over 65, why is it not OK for all?