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The Individual Mandate: Neither Essential Nor Enough (2-10-11)

"The Individual Mandate: Neither Essential Nor Enough"

Health Affairs blog posting by Carrie Valiant on February 10, 2011.

All eyes are focused on the many state challenges to health reform.  Florida's recent federal court decision held the entire health reform law unconstitutional, based on the unconstitutionality of th emandate requiring all U.S. citizens to maintain a minimum level of health insurance coverage beginning in 2014, or pay a penalty.  Virginia's earlier decision severed only the mandate and penalty, leaving the remainder of health reform standing.

Many believe the mandate is critical to ensure widespread participation in the state-run exchanges established by health reform, which in turn is key to affordable coverage.  Others have said that the Obama Administration needs a "Plan B" in the event the mandate and penalties are eliminated from health reform.  While ultimate judgment likely awaits a Supreme Court ruling, these court decisions raise important questions:  Is the mandate really essential to health reform's success?  More important, is the mandate enough to accomplish the goals of health reform?

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