Obamacare’s Individual Mandate Likely Candidate for Early Repeal


Obamacare’s so-called individual mandate requiring most people to have comprehensive health insurance that meets government requirements or pay a penalty is one of the most unpopular provisions of the 2010 health-care law. So it’s not surprising that provision is likely to be one of the first measures repealed by Republicans.

But, with Republicans poised to take over the White House and both houses of Congress in 2017, they will have to figure out how to ensure that people don’t wait until they’re sick to buy health insurance and drop coverage once they’ve received treatment.

Legislation passed by both houses of Congress in late 2015 would have repealed the individual mandate, but it was vetoed by President Barack Obama. The legislation is likely to be a model for what Republicans do in 2017.

President-elect Donald Trump has said he favors keeping the Affordable Care Act provision that requires health insurers to cover people with serious medical problems without charging them higher premiums than healthy people. That guaranteed-issue requirement without any penalty for not keeping coverage would likely lead to adverse selection in which only sick people buy nongroup health insurance while costs and premiums spiral out of control.

One idea being discussed is a Medicare-like requirement that people keep continuous coverage or pay higher premiums when they buy health insurance.

“We need to be talking about continuous coverage versus just increasing enrollment in each open enrollment period,” Calvin Anderson, chief of staff of BlueCross BlueShield of Tennessee, said. “It’s important to have continuous coverage. That’s what makes risk pools work.”

Another idea put forward by Gail Wilensky is to create exchanges that are similar to the popular Federal Employees Health Benefits Program (FEHB). Wilensky was in charge of Medicare and Medicaid from 1990 to 1992 during the administration of President George H.W. Bush.

Unlike the Obamacare exchanges, the FEHB, which is run by the federal Office of Personnel Management, offers a wide range of plans without mandates, Wilensky said. “There’s nothing formal about what they have to do. It’s quite actively managed without it being a matter of statute or regulations.”

The Department of Health and Human Services forecasts 13.8 million people to enroll for coverage in 2017.

Read the full story at //src.bna.com/kkR.

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