Without Individual Mandate, Fewer Californians with Health Insurance

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.