The vice president describes his party’s aspirational replacement for Obamacare as one that will “bring freedom and individual responsibility back to American health care.”
Keen-eyed health wonks will note the irony of Pence highlighting the importance of “individual responsibility.” Democrats cribbed the Affordable Care Act’s individual mandate from conservatives—who devised it to prevent free-riding in the insurance market—to such an extent that its provisions are spelled out in law under the heading of “individual responsibility.”
This is clearly not what Mike Pence means when he talks about replacing Obamacare with something that enshrines “individual responsibility.” The key to understanding what he means is the word “back.” Before the ACA, there was no “individual responsibility” requirement to maintain insurance, and, relatedly, no requirement that insurance companies sell insurance to everyone on the individual market at an affordable price. If you were sick, or poor, or sick and poor, you were very likely priced out of the market or denied coverage altogether. The only way to guarantee yourself access to the market was to show enough “individual responsibility” not to be sick or poor in the first place. That’s what Mike Pence wants to go “back” to.