Health Affairs – the academic journal for people who get excited about new Patient Protection and Affordable Care Act (PPACA) interim final rules – has published a paper about what might happen if Congress or the Supreme Court eliminates the PPACA individual coverage ownership mandate but leaves the rest of the law intact.
The authors, John Sheils and Randall Haught, work for the Lewin Group, Falls Church, Va., a unit of UnitedHealth Group Inc., Minnetonka, Minn. (NYSE:UNH).
Health insurers have argued that they need for the United States to require most people to have health coverage if the government is going to require health insurers on a guaranteed-issue, mostly community-rated basis.
Otherwise, health insurers and others have said, many consumers will buy health coverage only when they are sick, or expect to be sick, and escalating claims and premium costs will lead to a death spiral.
Critics of the PPACA individual health coverage mandate say the government should have no more right to order individuals to buy health insurance than it should have to order individuals to buy GM cars, or broccoli.
The Lewin Group analysts have estimated that, even if the individual mandate were eliminated, PPACA would still lead to 23 million previously uninsured U.S. residents gaining coverage.
Eliminations of the individual mandate could increase the total number of people who are uninsured in a few years to about 7.8 million, with 2.1 million fewer people having employer coverage and 4.5 million fewer people having individual or family commercial coverage, but coverage ownership might still be high enough that PPACA could work even if the ownership mandate went away, the analysts say.