You Want your Freedom and liberty from a Health Care Mandate? Put it in writing.

For those advocating personal responsibility when it comes to buying health care insurance, you may be getting your wish. While the Republican Party has silently pushed the idea that it’s okay to never buy health insurance, under the guise of protecting your freedom, the Democrats may have found a way to test that hyperbolic rhetoric:

Talkingpointsmemo: Rep. Peter Defazio (D-OR) proposes that people be allowed to opt out of the insurance mandate altogether -- but if they do, they will not be allowed to free-ride on the new health care system.

Under his plan, the Personal Responsibility in Health Care Insurance Act, a person opting out "must file an 'affidavit of personal responsibility' with the state exchange. Such a filing will waive their rights to: 1) Enroll in a health insurance exchange; 2) Enroll in Medicaid if otherwise made eligible; and 3) Discharge health care related debt under Chapter 7 bankruptcy law," DeFazio wrote in a letter to colleagues Tuesday.

Under his plan, if a person wants back into the system, they'd need to buy insurance on their own, out of pocket, for five years.  

Defazio: “In 2008, the uninsured received approximately $45 billion worth of uncompensated care from hospitals, doctors, and other providers, after out-of-pocket payments and government and charity program contributions. Oregon families pay an extra $1400 a year ($1,100 nationally) on higher insurance premiums to cover those who do not have insurance. This is effectively a hidden tax on families and businesses.”

The question is whether tweaks like this will create "adverse selection" in the insurance market. That's what would happen if the people who opt out are broadly healthier than the people who don't, and it would cause premiums to rise considerably.

Another plan is also being considered, keeping in mind Republicans would also have to approve the change:

TPM: One plan is modeled on an existing incentive built into the Medicare prescription drug benefit: Create an open-enrollment period for people who want to buy health insurance, and assess a penalty on anybody who tries to enter the insurance market after that window closes.

This idea would surely get Republican support, since it is the same option they are now desperately trying defend in their Medicare Part D mandate.