Starting in the early 1980s, up through well into 2009, the individual mandate was an eminently respectable Republican position, embraced by conservative policy wonks and leading Republicans. Since then, virtually the whole of the conservative movement has coalesced around the position that the individual mandate is not merely misguided but actually unconstitutional, a fact conservatives somehow overlooked during the previous three decades.
Indeed, conservatives now believe that the policy they once embraced (or at least tolerated) would amount to an abrogation of the very principle of limited government. The conservative argument, reflected in Republican judge Henry Hudson’s ruling against the individual mandate, is that purchasing health insurance is the ultimate individual decision, and that abridging this liberty would, in Hudson’s words, “invite unbridled exercise of federal police powers.” If the individual mandate is permissible, writes George Will, then “Congress can doanything - eat your broccoli, or else - and America no longer has a limited government.” Megan McArdle echoes, “On a reading of the commerce clause that allows the government to force you to buy insurance from a private company, what can't the government force you to do?”
This is the intellectual rationale for the hysterical conservative response to the pasaage of health care reform. By this line of reasoning, the individual mandate springs from a paternalistic desire to compel individuals to engage in behavior that affects nobody but themselves.
But of course, the decision not to purchase health insurance is the very opposite. Those who forego health insurance are forcing the rest of us to cover their costs if they exercise their right to be treated in an emergency room. They are also forcing the rest of us to pay higher insurance rates, now that insurance companies can no longer exclude those with preexisting conditions. That, of course, is exactly why conservatives supported it for so long.
Conservatism's sudden lurch from supporting (or tolerating) the individual mandate to opposing it as a dagger in the heart of freedom is a phenomenon that merits not intellectual analysis but psychoanalysis. This is simply how conservatives respond in the face of every liberal advance. At such moments the nation is always teetering on the precipice between freedom and socialism. The danger never comes to pass, yet no lesson is ever learned. We simply progress intermittently from hysterical episode to hysterical episode.
In the right-wing mind, the world we live in at any given moment can be described as the free market, the American way of life, perhaps not a perfect world but a cherished and fundamentally free one. The nextadvance of liberalism will always bring socialism, tyranny, a crushing burden on industry, and other horrors. The previous liberal advances that they or their predecessors greeted with such hysteria are eventually incorporated into the landscape of the free American way of life.
That is how in forty years conservatives could progress from dire warnings about the danger of Medicare to virulent defenses of Medicare against Democratic plans to trim its waste. Conservatism's virulent turn against the individual mandate is simply a case of the normal pattern working in reverse – a sound, free market policy eventually transmutes into the Death of Freedom, rather than vice versa.