Can the Individual Mandate clause be really dissolved without seriously harming the rest of the law? If yes, then what can be the possible ramifications of such a Supreme Court ruling?
A group of 103 economists filed for an amicus brief that insists that the Individual mandate clause is so inextricably intertwined with the rest of the Affordable Care Act (ACA), that it cannot possibly be severed from the ACA. Our curiosity piqued, our team at hCentive tries to envision a U.S. health industry without an Individual mandate directive.
Listed below are some of the possible consequences of an ACA without its Individual mandate.
Increase in the number of uninsured
As per the Census Bureau’s 2011 Current Population Survey, America had 49.9 million uninsured Americans in 2010, a figure marginally higher than the 49 million who were uninsured in 2009. An independent study conducted by Robert Wood Johnson foundation analyzed that the removal of the Individual Mandate would result in fewer people with private insurance as compared to a scenario where the ACA had never been implemented in the first place.
Escalating insurance costs
The Individual Mandate tries to offset high premium rates by driving healthy people into the insurance system.
If every citizen is not mandated by law to purchase insurance and there is no underwriting then, insurance will primarily be bought by sick individuals and healthy individuals will put-off buying insurance until they fall ill. The premium rates will escalate and rising premiums will force many individuals to drop coverage, resulting in further increase in the premium rates. The vicious cycle may continue until the coverage becomes so expensive that no one can afford it anymore and the entire insurance system may collapse.
Impact on the pre-existing condition clause
ACA prohibits private insurers from charging higher premiums or denying coverage to individuals on the grounds of pre-existing medical conditions. If the number of healthy people dropping their coverage becomes greater than the number of chronic patients gaining coverage under the ACA, the health insurance market may de-stabilize and many private insurers may be driven out of the market. The Individual Mandate seeks to put a check on such anomalies by encouraging healthy people to get insured irrespective of their health conditions.
World of ACA without the ‘Individual Mandate’
If the Supreme Court rules that the Individual Mandate is indeed unconstitutional and needs to be repealed, then alternative solutions circumventing the mandate but still very much in compliance with the rest of the ACA, may need to be considered.
Last year, the U.S. Government Accountability Office released a report that assesses possible alternatives to the Individual Mandate as proposed by over 40 health care and health insurance industry experts. The report includes suggestions such as issuing penalties for late enrollments, revising open enrollment periods, conducting public education programs, facilitating auto-enrollment for employers, to name a few.
Despite much public misgiving against the Affordable Care Act, the ACA has already proven its mettle in certain areas, such as ensuring insurance to youths until they turn 26 and checking insurers from denying insurance coverage to individuals with pre-existing medical conditions.