In the 1970's, during the Nixon Administration, the Democratic Party began to advocate for a single payer plan to insure all Americans. Nixon and his party disliked the plan and explored alternate approaches, which included mandated health insurance for all Americans. Comprehensive reform was not successful in gaining enough Congressional traction to evolve into legislative action.
During the George H. W. Bush Administration, Senator Ted Kennedy from Massachusetts was pushing a Single-Payer system as a solution for the health care problem, and Conservatives pushed back with a defined Individual Mandate. Bush's plan, came from a health systems economist named Mark Pauly, was to tie the individual mandate to taxation, with means testing based on income that would effect the amount a person would have to pay. This would have catastrophic coverage, which would've left a number of large holes in the program. Also included was a clause that would cover all pre-existing. Two basic components of the Affordable Care Act.
Things crystallized further during the Clinton Administration and Hillary Clinton's efforts to address health care. Republicans, fighting back once again, submitted a formal proposal, "Coverage of Preventative Services: Provisions of Selected Current Health Care Proposals." This proposal included, on page 25, a provision for an individual mandate.
The line of Conservatives who supported this idea is a rather long one. It includes conservative watch dog group The Heritage Foundation. It also includes such high profile republicans Newt Gingrich, Mitt Romney, Orrin Hatch, Chuck Grassley, Bob Dole, Jim DeMint, Jon Huntsman, Mitch Daniels, Robert Bennett, Christopher Bond, Bill Frist, John McCain and Tommy Thompson. Not to mention the Nixon and Bush Sr. Administrations.
