Repeal the Individual Health Insurance Mandate

Discussion in 'Healthcare Reform Discussions' started by N. A., May 6, 2020 at 7:15 PM.

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  1. N. A.

    N. A. Guest

    The current mandate (ACA) requires every individual to have insurance or pay a penalty. In 2018 about 27.5 million or 8.5% of Americans not have any insurance for the entire year. The prior year in 2017 it was 7.9% (census.gov, 2019). The number of individuals that had health insurance for any part of the year was also lower than 2017, in 2017 92% had insurance and in 2018 it was 91.5% (census.gov, 2019). There were not significant changes in purchase coverage such as Tricare, VA and CHAMPVA health during the years of 2017-2018 (census.gov, 2019). The number of uninsured children actually saw an increase of 0.6%.

    The current law while not perfect does assist many in having some kind of coverage. Under the current mandate it is estimated that some 28 million individuals under 65 would have no insurance by 2026 (cbo.gov, Nd). The number would change to 43 million by 2026 if current law is repealed. Employee coverage would see a reduction of about 2 million, it’s estimated about 6 less would purchase nongroup policies, and 7 million less would qualify under Medicaid (cbo.gov, Nd). It is possible that an increase in cost would also be seen in coverage that is purchased in the nongroup market.

    Before the ACA insurers could deny at risk applicants and charge more based on age and sickness. They could also exclude certain benefits, refuse to cover mental health and deny coverage for preexisting conditions. The ACA addressed these issues and ensured that comprehensive coverage was offered to everyone, with rates that do not vary based on health and that includes preexisting health conditions. The act also offered tax credits to those who purchase from the individual market and qualify based on income. The law also included a Medicaid expansion so that more children and adults would qualify.

    I personally like the idea that Canada has by qualifying ever citizen or permanent resident for public health care which comes out of taxes. The downside to offering something to everyone is there can be waits to qualify for coverage, up to a few months and waits for services and those can be much longer. You still have to pay for some additional services, as the government plan in Canada only covers basic medical services. I would like to see something where we include more people that is perhaps income based with a cap on the monthly fee, so it can never exceed say $250 per month for a family regardless of family size.

    If you are uninsured you do have rights, but it needs to be emergency care. This would be severe or life threatening, if your organs or body functions are severely impaired or if you are pregnant and the baby is coming. You are responsible for the full cost of care, though you can ask for charity care or see if any discounts are available. If we increase the number of uninsured individuals, we will then see people not seeking routine care if they no longer qualify for Medicaid. That means more things will be missed such as early cancer detection which is critical to treatment. It also means they will not even be able to afford treatment if they get seriously ill. The individual mandate in a sense pressured more individuals to purchase care, but in the long run having coverage keeps you healthier and ensures when you or your family get sick you are able to seek care. If uninsured a hospital can deem your care a non-emergency and send you home without even trying to see what is wrong.


    References:

    Eibner, C., & Nowak, S. (2018, July 11). The Effect of Eliminating the Individual Mandate Penalty and the Role of Behavioral Factors. Retrieved May 4, 2020, from https://www.commonwealthfund.org/publications/fund-reports/2018/jul/eliminating

    The Effect of Eliminating the Individual Mandate Penalty and the Role of Behavioral Factors | Commonwealth Fund

    US Census Bureau. (2019, November 8). Health Insurance Coverage in the United States: 2018. Retrieved May 4, 2020, from Health Insurance Coverage in the United States: 2018

    OPTIONS FOR REDUCING THE DEFICIT: 2017 TO 2026. (2016, December). Retrieved May 4, 2020, from https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/reports/52142-budgetoptions2.pdf