An individual mandate coupled with subsidies for private insurance as a means for universal healthcare was considered the best way to win the support of the Senate because it had been included in prior bipartisan reform proposals. The concept goes back to at least 1989, when the conservative Heritage Foundation proposed an individual mandate as an alternative to single-payer health care. It was championed for a time by conservative economists and Republican senators as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of free rider problems. Specifically, because the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA) requires any hospital participating in Medicare (nearly all do) to provide emergency care to anyone who needs it, the government often indirectly bore the cost of those without the ability to pay.
That’s from the Wikipedia page on the ACA.
It was a Republican idea. It was their idea because it didn’t hamper the private sector of insurance by introducing a single payer system.
Then, when the Democrats decided they could get behind the idea, all the Republicans suddenly hated it. And as you say, not a single one voted for their own conservative idea. In fact, they resisted at every turn.
And it is this resistance that has hampered the act’s efficacy, since the majority of state don’t have marketplaces and other setups meant to bolster the law.
I’m speaking truth. I have no desire to be divisive. But here’s my perspective, people in this country need to know what kind of people their elected officials are. Obamacare was a Republican idea that has been demonized and vilified by the same people who came up with it!
These people have no desire to make American lives better. They don’t want to help us! They want to win! They want the personal bragging rights and the cushy lifestyle. That’s it. And it’s all bullshit.