What a Supreme Court Decision to Eliminate the Individual Mandate Could Mean for Coverage and Costs, The Urban Institute Health Policy Center, June 22, 2012
The U.S. Supreme Court is expected to rule soon on the constitutionality of the Affordable Care Act’s individual mandate. Without the mandate, the ACA would be less effective in reducing the number of uninsured and cutting the cost of uncompensated care. However, even if the High Court rejects the mandate, policies such as late enrollment penalties and excluding care for pre-existing conditions for a period of time could preserve high levels of coverage in the ACA. As enacted, the ACA would cut the number of uninsured nearly in half—from 50 million to 26 million, according to an analysis by the Urban Institute’s Health Policy Center. However, if the High Court eliminates the mandate but retains all other provisions of the health reform law, the number of uninsured will fall by much less—to 40 million. Overall health spending would change relatively little under the ACA, with or without the mandate. However, government, employer, and individual spending would fall slightly without the mandate because fewer people would have coverage. Uncompensated care would fall from $78 billion without the ACA to $39 under the full health reform. But without the individual mandate, the ACA would reduce uncompensated care to only $59 billion.”