NEW YORK, NY – As the debate over health care continues, it is becoming clear that the importance of the individual mandate to the Affordable Care Act’s exchanges has been greatly exaggerated. As a new Manhattan Institute issue brief shows, it has done little to increase enrollment, to reduce insurance premiums, or to alleviate the burden of uncompensated care.
Rather, as senior fellow Chris Pope demonstrates, the main effect of the individual mandate has been to concentrate more of the expense of covering the chronically ill on the relatively small cohort of working Americans who lack employer-sponsored coverage. By doing so, the provision has served to obscure the total cost of the entitlement.
Pope’s findings include:
- Between 2015 and 2016, when the mandate penalty was increased, the number of uninsured fell by only 0.2 million, while total enrollment in nongroup markets even shrank by 0.2 million—a statistically insignificant shift.
- The 27.2 million remaining uninsured in 2016 still well exceeds the 18.0 million who chose to enroll in the individual market as a result of the mandate.
Pope concludes by noting that the ACA has achieved some success in guaranteeing a defined benefit as a safety net for low-to-medium-income individuals and those with preexisting conditions. But by seeking a one-size-fits-all system, it has contributed to rising premiums, narrowing networks of providers, and soaring deductibles.