It has not served to make health insurance more affordable and attractive.
This November, the Supreme Court will hear arguments in the case of California v. Texas, which centers on the constitutionality of the 2010 Affordable Care Act (ACA), also known as Obamacare. The case — which is gaining renewed attention in the wake of Justice Ruth Bader Ginsburg’s death — will focus specifically on the legitimacy of the ACA’s individual mandate, the necessity and effectiveness of which have been points of contention among scholars for years.
But they need not be. New findings from the Census Bureau released last week have effectively settled the debate, confirming that the mandate’s repeal in 2019 by the Tax Cuts and Jobs Act did not significantly lower health-insurance coverage levels in the United States. The better question to ask is why did the individual mandate fail in its intended purpose to increase enrollment?
The Congressional Budget Office originally estimated that the absence of the individual mandate would increase the number of Americans without health insurance by 16 million. Economists advising the Obama administration argued it would be 22 million. These estimates were both astonishingly far from the mark. The Census Bureau’s newly released results from two surveys of health-insurance coverage for 2019, the first year for which the mandate had been repealed, tell a vastly different story: One estimate shows that the number of Americans without health insurance increased by only 1 million; the other that it actually fell by 1 million.
Chris Pope is a senior fellow at the Manhattan Institute and author of a recent report, “Taking the Strain Off Medicaid’s Long-Term Care Program.” Follow him on Twitter here.
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