In April 2006, Massachusetts passed an “individual mandate” bill, legislation which requires all residents to buy a private health insurance plan or face a tax penalty. Some subsidies are provided for low-income residents, and a new state agency was created to assist residents in finding a plan. Two months later the American Medical Association endorsed the mandate concept and a number of state legislatures introduced copycat bills.
But as Drs. David Himmelstein and Steffie Woolhandler point out in this editorial response, individual mandates offer a false promise of universal coverage. Mandate proponents promise comprehensive coverage at a low cost, but the exorbitant price of private coverage (averaging $3,500 for an individual and $10,000 for a family) means that many families will have to decide between financial hardship and low-premium plans that offer no coverage worthy of the name.
Moreover, individual mandates do nothing to control the rising cost of care, continuing to funnel health dollars though wasteful private insurers and hospitals. Instead, they mandate that cost of covering the uninsured should be incurred by the uninsured themselves.