Vice President for Health Policy
In addition to the sharp funding cuts we noted yesterday, another major component of the legislative blueprint some House Republicans issued yesterday is near-full repeal of the Affordable Care Act (ACA) — i.e., health reform. In its place, the House Republicans propose the same policies they offered as an alternative to health reform last fall.
Moreover, at the same time that the blueprint would repeal the ACA’s requirement that individuals have health coverage or face a penalty, it purports to keep several of the law’s popular insurance-market reforms, such as the rules preventing insurance companies from denying coverage to people with pre-existing medical conditions or from placing lifetime caps on covered benefits.
As this Center report explains, implementing the insurance market reforms without an individual mandate would be doomed to failure. In fact, such an approach would make health coverage less affordable, not more so because:
It was precisely to prevent this from happening that policymakers included the individual mandate in the ACA.
Our report also notes that criticisms of the individual mandate echo arguments from Social Security’s opponents back in the 1930s:
Opponents of the individual mandate make many of the same arguments that opponents of Social Security made when it was first enacted. At the time, some argued that requiring people to pay a portion of their wages into Social Security was an infringement on personal liberty and an oppressive burden that the federal government had no right to impose.
Over time, however, the vast majority of people have come to recognize the value of protecting America’s seniors through Social Security. Mandatory Social Security provides critical help to people who hoped to save enough on their own for their retirement but didn’t succeed in doing so or were wiped out by an unexpected catastrophic cost, disability, or the loss of employment.
Similarly, the individual mandate will protect people who are healthy now and don’t think they need insurance but subsequently develop a serious illness or have a serious accident and otherwise would face exorbitant costs for care and possibly be forced into medical bankruptcy. It is an essential part of a package of health reforms that will move the nation a long way toward achieving another valued, common goal: quality, affordable health coverage for all Americans.