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Report: Replacing the Individual Mandate would Significantly Erode Coverage Gains and Raise Premiums for Health Care Consumers

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Center for American Progress – Health Care Reform without the Individual Mandate, Replacing the Individual Mandate would Significantly Erode Coverage Gains and Raise Premiums for Health Care Consumers, by Jonathan Gruber, February 2011

  • “A central pillar of the recently enacted Patient Protection and Affordable Care Act is the individual mandate, the requirement that all individuals for whom insurance is affordable purchase such coverage or pay a tax penalty. Yet this is also one of its most controversial elements. In recent public opinion polls, the individual mandate is rated as one of the least popular elements of the new health law. And recent court decisions on the constitutionality of the individual mandate have reached mixed conclusions, with two courts upholding the mandate and two striking it down. So what happens to health care reform if the mandate is repealed? And is there a reasonable alternative? This issue brief answers both of these questions. In particular, I consider the two most-discussed alternatives to the mandate and estimate their impact on insurance coverage, public sector costs, and insurance prices. I find that both alternatives significantly erode the gains in public health and insurance affordability made possible by the Affordable Care Act.
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