The Affordable Care Act includes a provision that requires Americans to have health insurance, known as the individual mandate, otherwise pay a penalty collected by the IRS. An option for reducing the budget deficit is to repeal this mandate and no longer require Americans to purchase insurance. The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) estimates a total savings of $416 billion between 2018 and 2026 if the individual mandate is repealed (Congressional Budget Office, n.d.). Supporters of this repeal argue that health coverage is a personal decision, and the federal government should not decide whether people must have insurance or not. This mandate reduces the financial well-being of individuals and families by forcing them to either purchase coverage or pay a penalty. In 2015, 6.7 million Americans paid the tax penalty instead of purchasing health coverage with a majority of them being in the low to middle income group of $25,000-$50,000 (Lai & Parlapiano, 2017). And lastly, young and healthy people who can afford coverage but would normally not purchase it are cross-subsidizing for the older, less healthy people who use many more services (Congressional Budget Office, n.d.). And unfortunately, having health coverage does not guarantee access. Some networks have limited access to providers and specialists due to lack of a contract. This forces enrollees to choose one of the providers in network, even if they are not as qualified as another physician (U.S. Department of Health & Human Services, 2017).
By 2026, 28 million Americans will be uninsured. If this mandate were to be repealed, an additional 15 million people will not have health coverage (Congressional Budget Office, n.d.). Healthy individuals who only purchase insurance due to the penalty will stop. This will increase the ratio of unhealthy beneficiaries to healthy beneficiaries and cause insurance premiums to rise to offset costs. Another anticipated consequence includes shifted costs onto hospitals. Once the mandate is repealed, people who cannot afford insurance will stop purchasing it. Yet they may still get sick or have a medical emergency and show up at a hospital for medical care without being able to pay for it. This will certainly affect hospitals with the anticipated increase in uninsured admitted patients. These costs will be left with the hospital to recover through cost shifting and raising costs for private insured patients. It is estimated that each uninsured person costs hospitals $900 per year (Garthwaite, Gross & Notowidigdo, 2015).
By 2026, 28 million Americans will be uninsured. If this mandate were to be repealed, an additional 15 million people will not have health coverage (Congressional Budget Office, n.d.). Healthy individuals who only purchase insurance due to the penalty will stop. This will increase the ratio of unhealthy beneficiaries to healthy beneficiaries and cause insurance premiums to rise to offset costs. Another anticipated consequence includes shifted costs onto hospitals. Once the mandate is repealed, people who cannot afford insurance will stop purchasing it. Yet they may still get sick or have a medical emergency and show up at a hospital for medical care without being able to pay for it. This will certainly affect hospitals with the anticipated increase in uninsured admitted patients. These costs will be left with the hospital to recover through cost shifting and raising costs for private insured patients. It is estimated that each uninsured person costs hospitals $900 per year (Garthwaite, Gross & Notowidigdo, 2015).
