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An Individual Mandate to Obtain Health Insurance Coverage
NAHU has historically approached the idea of an individual mandate to obtain health insurance coverage with great caution. Similar mandates for auto insurance coverage have failed to reduce the number of uninsured motorists. We also have concerns about whether or not a government requirement to purchase any good or service is both inherently fair and even constitutional. However, in addition to reforming our nation's private sector health insurance markets so that they operate more fairly, we need to ensure that as many Americans as possible purchase and maintain private health insurance coverage. The best way to do that is to make private health insurance coverage more accessible and affordable through cost-containment changes and reasonable market reforms. Other ideas to encourage more Americans to join the private coverage system include:- Insurance-related consequences for healthy people who forego coverage but subsequently attempt to obtain coverage if needed when sick or injured. Such individuals should be subject to late-enrollment penalty in addition to other penalties for those who have more than a 63-day break in coverage. Both Medicare Part B and Medicare Part D have such penalties for a very good reason.
- An annual open enrollment period for individuals to purchase coverage under the guarantee-issue provisions and to allow plan changes. Exceptions should be made for individuals who undergo a life-changing event, such as the addition of a new child or a change in employment. The HIPAA qualifying event standards in current law could serve as a model for these exceptions.
- An increase in the role of employers in health insurance enrollment. Health insurance coverage should not be required to be offered by an employer but, if it is, newly eligible individuals in available employer-sponsored health insurance plans could be auto-enrolled in groups of 50 and more with an employee opt-out. In addition, if federal assistance were provided to even smaller employers to assist with the associated administrative costs, it is possible that they could auto-enroll newly eligible people
NAHU Issue Summary on Encouraging Americans to Purchase and Maintain Health Insurance Coverage A detailed overview of NAHU's ideas regarding personal responsibility requirements in health reform.
Oliver Wyman/BCBSA Analysis of H.R. 3950 A December 2009 Oliver Wyman/BCBSA analysis of H.R. 3590 shows how the ineffective individual mandate enforcement provisions in H.R. 3590 would actually raise health insurance costs for millions of Americans. Individual Mandate Op-Ed Issue Summary on an Individual Mandate This paper outlines NAHU's key talking points on how to make an individual mandate effective and enforceable. Individual Mandate White Paper This paper prepared by the NAHU Legislative Council and Board in 2007 discussing various issues involved with the creation of an individual mandate to obtain coverage.
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