Christine Ferguson is the one Rhode Islander who has been most vindicated by the U.S. Supreme Court upholding the so-called individual mandate aspect of the Affordable Care Act that requires everyone to have health insurance coverage.
Ferguson, of Jamestown, was chosen last week by Governor Lincoln Chafee to head the state’s new Health Benefits Exchange that hopes to move Rhode Island toward universal health care coverage.
Ferguson has been fighting the battle for an individual mandate since the early 1990s, when she was Sen. John Chafee’s health care guru. At the time, the individual mandate was the Republican answer to the Hillarycare employer mandate that was advanced by then-President Bill Clinton. Chafee’s plan won support from Bob Dole, then the Senate’s GOP leader and from Newt Gingrich, then a rapidly rising House GOP leader.
The mandate was originally a conservative idea, developed as a Republican counter to the Democratic single-payer plans based on the Canadian model that was pushed for many years by some prominent Democrats, including Sen. Ted Kennedy and Walter Reuther, president of the United Automobile Workers union.
Reaching back even further, Richard Nixon, elected in 1968, was the first Republican president who advanced a plan for universal care via private insurance companies.
In the early 1990s though, the individual mandate as a vessel for moving toward universal coverage through private insurers was endorsed by the conservative Heritage Foundation, a Washington, D.C., think tank.
Before the ascension of the Tea Party and libertarian thought in the national Republican Party, the mandate was viewed as a conservative plan that combined the virtue of individual responsibility with a path to end the cost-shifting that has long plagued the American health care system.
Chafee’s plan fizzled (so did Clinton’s). But Ted Kennedy said years later that he made a mistake and acknowledged that he should have joined with Chafee to move toward universal care with a mandate.
But Ferguson never gave up on it. When she became health commissioner in Massachusetts in 2003 under then-Gov. Mitt Romney, Ferguson was pivotal in helping to convince Romney that the mandate was the way to go in developing Massachusetts’ first-in-the-nation universal health care plan.
In an insightful article in the June 6, 2011 New Yorker, staff writer Ryan Lizza tracked the genesis of Romneycare. When Romney aides went looking for a solution to the problem of access to health care, they consulted Ferguson.
“We got the idea from Christy Ferguson,’’ a Romney aide told the New Yorker.
“At one of our early meetings she brought up the idea of the individual mandate and said, “We need to look at that. Don’t assume that because he is a Republican governor that he is not going to want an individual mandate.’’
The rest, of course, is history. Romneycare was approved in Massachusetts (with Kennedy’s help). Now, of course, Romney has bowed to the Tea Party and vows if he is elected to the White House to repeal the Affordable Care Act.