The unpopular Obamacare individual mandate has failed its intended mission of getting people to sign up for coverage.
The individual mandate, a key component of the Affordable Care Act, “is failing to stabilize the health insurance marketplace,” Rep. Vern Buchanan (R-Fla.), chairman of a House Ways and Means Committee panel, said at a hearing I covered Jan. 24.
But the mandate may not be in effect much longer, in any event. President Donald Trump issued an executive order Jan. 20, his first day in office, requiring executive agencies implementing the ACA “to waiver, defer, grant exemption from, or delay the implementation of any provision or requirement” that would impose a fiscal burden on states or individuals.
The order is widely interpreted to mean that the mandates on individuals and small businesses to buy coverage will be waived altogether.
About 6.5 million taxpayers paid $3 billion in penalties for not maintaining qualified coverage under the 2010 health-care law and about 12.7 million filed for an exemption from the mandate, John Graham of the conservative National Center for Policy Analysis testified.
In contrast, only 7.3 million taxpayers received subsidies to buy policies in the ACA exchanges, Graham said.
“The coverage through Obamacare is not through enforcing any kind of individual mandate. It’s through more government dependency on Medicaid, which is costing us far more than we’re getting from an individual mandate,” Graham said.
In 2016, the Congressional Budget Office increased its estimate for Medicaid enrollment of people under age 65 to about 68 million through 2019, an increase of about a third from the original estimate the CBO made in 2010.
Harvard School of Public Health Professor John McDonough, who supports the ACA, testified that the individual mandate is necessary because the ACA requires health insurers to sell plans to people with health problems without charging them more.
In the 1990s, eight states tried imposing a guaranteed issue requirement on health insurers without requiring individuals to have insurance, McDonough said. The result was disruption in the health insurance individual market as many people waited until they needed medical care to buy coverage, and then dropped it after they received treatment, he said.
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