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Topics of interest to both consumers and agents related to Covered California and the ACA biased in favor of the successful implementation of the Exchange and deliberately apolitical.

Consequences of ACA Without Individual Mandate

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A recent Urban Institute report* examines what would happen to premiums, coverage, and uncompensated care if the individual mandate is eliminated from the Affordable Care Act (ACA).

Without the individual mandate — the requirement for most Americans to have health insurance or face a penalty — the analysis reveals costs would rise, fewer individuals would be insured, and uncompensated care spending would be much higher.


The report shows a potential 25% premium hike.

Insurance premiums would rise by as much as one quarter nationwide if the health care law is implemented without the individual mandate.

If the individual mandate was cut the report highlights other main points: (click image to enlarge)

  • Private coverage would fall by 11 million nationwide, covering four million fewer people than it would have without reform.
  • Between 40 and 42 million nationwide would remain uninsured, as opposed to 26 million with the mandate.
  • Uncompensated care spending would be much higher due to the increased number of the uninsured.

Co-authors Matthew Buettgens and Caitlin Carroll, estimate the effects of ACA and the individual mandate by using the Urban Institute’s Health Insurance Policy Simulation Model (2011), which simulates decisions of businesses and individuals in response to policy changes such as new health insurance options, subsidies for the purchase of health insurance, Medicaid expansions and insurance market reforms.

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