(s_falkow: Flickr)
(s_falkow: Flickr)

In March, the U.S. Supreme Court will consider the constitutionality of several aspects of health care reform, including the “individual mandate,” the requirement that all Americans have health insurance.

In a new study, [PDF] researchers at the UCLA Center for Health Policy Research and UC Berkeley crunched the numbers and determined that without the individual mandate, more than one million Californians would put off buying health insurance.

The individual mandate is part of The Affordable Care Act, set to roll out in 2014. The mandate requires people to purchase health insurance or pay a tax penalty up to $2085 per household.

“There no question that the mandate makes a huge difference in bringing people under the umbrella of coverage,” Gerald Kominski, co-author of the study, said in a press release. “Eliminating the mandate will undermine the goal of health care reform to substantially increase health insurance coverage for the uninsured.”

In addition, if there’s no mandate, the researchers say the state insurance market will continue to see “adverse selection,” meaning people who have serious health conditions are most motivated to obtain health insurance. With fewer healthy people buying insurance, it’s harder to spread risk. This situation drives up health care costs, which translates to higher costs of health insurance itself. The higher premiums will further push people out of the health insurance market, the researchers believe.

The study was funded by The California Endowment, which also supports KQED.

In another health care reform story today, the Kaiser Family Foundation released its January Health Tracking Poll. The survey showed that most Americans believe the Supreme Court Justices will base their rulings about health care reform on their own personal views, rather than interpretation of the law.

More specifically, the poll found:

Three-quarters (75%) say they think that, in general, Justices let their own ideological views influence their decisions while 17 percent say they usually decide cases based on legal analysis without regard to politics and ideology.  Similarly, when asked specifically about the challenge to the individual mandate in the health reform law, six in ten (59%) Americans say they expect the Justices will take their own ideological views into account, while 28 percent think their decision will be based purely on legal analysis and interpretation.

As for the individual mandate itself, more than twice as many Americans have an unfavorable rather than favorable view of the mandate (67% to 30%).  This is line with prior Kaiser polls. More than half of those polled (54%) said the Court should rule the individual mandate unconstitutional.
Without Individual Mandate, Fewer Californians with Health Insurance 23 March,2012Lisa Aliferis


Lisa Aliferis

Lisa Aliferis is the founding editor of KQED’s State of Health blog. Since 2011, she’s been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including Dateline NBC and San Francisco’s CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for “Best Topical Reporting” from the Online News Association. You can follow her on Twitter: @laliferis

State of Health Sponsored by

Become a KQED sponsor