Canonizing an Individual Mandate

The Trump administration has so far been unable to pass a healthcare bill, but the one thing they have done is repeal the Affordable Care Act’s individual mandate requiring purchase of health insurance. That’s unfortunate, because it is impossible to get insurance companies to overlook pre-existing conditions without an insurance mandate.

It’s bizarre that the individual mandate became the bedrock of the conservative case against Obamacare, because conservatives once championed such a thing as a viable alternative to a single-payer system. Yet they have suddenly – and relatively recently – decided that this is the most hideous aspect of the law, the death of freedom, and the rise of Big Brother.

Now there is a legitimate argument as to whether or not this should be a federal responsibility, but there is no legitimate argument that maintains that an insurance pool can survive if people can wait until they get sick before they join it. Without an individual mandate, at least on a state level, the government will be forced to provide subsidized coverage to the chronically ill, which will likely be more expensive than a mandate would be.

I’m offering not so much as an endorsement of a mandate, but rather a recognition of a mathematical reality. As of now, there are three approaches to providing universal coverage – Medicaid, an insurance mandate, or the kind of leaky-bucket emergency room approach that was the standard before the ACA. There is also the option of letting the poor suffer and die for lack of coverage, which, to me, is not an acceptable option.

What do you think are acceptable options? Join or start a camp below.