Drudge, Fox Nation and Breitbart distorted comments made by House Minority Leader Nancy Pelosi to claim she "trashed the uninsured" by calling them "free riders." Pelosi's comments were not directed toward all uninsured Americans, but were specifically referring to health care consumers who remain uninsured until they have a health care need, overburdening the market and increasing health care costs. This is a claim almost identical to policy recommendations made by Mitt Romney in a 2009 op-ed.
In a recent interview with San Francisco's KQED radio, Pelosi pointed out that Thursday's Supreme Court decision to uphold the Affordable Care Act in its entirety meant "goodbye to the free riders." In the comments that followed, Pelosi made it clear that she was referring to people who "just decide you're not going to apply for health insurance" and then when "[y]ou get sick or in an accident, your health care costs are a burden to everybody else."
Breitbart's Joel Pollak acknowledged that Pelosi defended the penalty as " necessary because some (many?) of the uninsured actively choose not to buy health insurance, even though they can afford it." But these were the very people Pelosi was talking about when she discussed free riders - not everybody without insurance. That fact is obscured by the Breitbart headline, which was highlighted by Drudge and Fox Nation.
The difference between Pelosi's comments and Pollak's suggested interpretation is significant. Pelosi was not referring to people who currently have no ability to access or afford health care coverage, but to those who have the resources to purchase insurance but choose not to, making their eventual care a liability for themselves and to taxpayers. Because the low-income premium subsidies in the Affordable Care Act make health insurance affordable for millions more people, and the group previously labeled "free riders" will largely consist of those who refuse to pay for health care instead of being simply uninsured due to a lack of affordability.
Pollak also ignored the fact that Pelosi is not the only person to celebrate individual responsibility measures as a way to combat the "free rider" problem. In a 2009 USA Today op-ed, which has since been removed but still exists in archives, GOP presidential hopeful Mitt Romney advocated the use of "tax penalties" or "tax credits" to make free riders "take responsibility for themselves. From the op-ed:
Our experience also demonstrates that getting every citizen insured doesn't have to break the bank. First, we established incentives for those who were uninsured to buy insurance. Using tax penalties, as we did, or tax credits, as others have proposed, encourages "free riders" to take responsibility for themselves rather than pass their medical costs on to others.
Here are Pelosi's full comments from the KQED interview (emphasis added):
PELOSI: I would say it's goodbye to the free riders. There are people who are free riders who now have a responsibility to have health insurance or pay a penalty.
If you're a healthy younger person, you have resources, you just decide you're not going to apply for health insurance. You get sick or in an accident, your health care costs are a burden to everybody else. You go to the emergency room and that increases everybody's costs.
That's just not fair, especially if you multipl[y] it by many many people. The ones who can opt out because they feel invincible - I've had them blowing through my office. People who thought they'd never be in an accident or get breast cancer or never thought they'd get a diagnosis of rare blood this or that. And then they're up the creek.
The point being you can call it whatever you want, but it is a penalty for free riders, who get health care without paying for insurance, increasing the cost to others.