Though Republican lawmakers now vilify the individual mandate for health insurance coverage as unconstitutional, the provision has long roots in conservative health care philosophy and has been supported by such GOP presidents as Richard Nixon and George H.W. Bush. Republican administrations were among the first to embrace the concept of forcing individuals to buy coverage. Nixon — hoping to stave off the single-payer ethos of many congressional Democrats — explored the idea in the 1970s, though Republicans now dismiss those discussions as the byproduct of a moderate president searching for a domestic policy victory.
Less than two decades later, in what remains an unexplored chapter of health care history, a surprising supporter of the individual mandate was George H.W. Bush. According to contemporaneous reporting, Bush used "the tax system to ‘encourage and empower’ individuals to buy health insurance and would enact insurance market reforms that make it possible for everyone — even if they have pre-existing health problems — to get insurance." In short: individuals would be mandated to buy catastrophic health insurance. The cost of that coverage would be tied to income, meaning that the poorer you were, the less expensive your policy would be.
Coverage of Preventive Services Provisions of Selected Current Health –
Individual Mandate, Now Vilified By GOP, Was Supported By George H.W. Bush