Thursday, July 30, 2015

Who would bear burden of Obama's health insurance mandate?

One percent represents the tiny portion of the population that is likely to actually bear the burden of the mandate to obtain health insurance contained in Obama's health reform law.

Who would bear burden of Obama’s health insurance mandate?


One percent of the population.

It sounds like a very small number. That’s the miniscule slice of Americans that, according to the Occupy Movement, owns a disproportionate share of the country’s wealth.

One percent also represents the tiny portion of the population that is likely to actually bear the burden of the mandate to obtain health insurance contained in Obama’s health reform law.

The estimate is based on experience under the Massachusetts health reform plan, which took effect in 2006. That’s the system supported by then-Governor Mitt Romney that Obama’s law is modeled on.

Only about one percent of state residents actually paid a penalty under that law for going without health insurance in 2009. And the number has gone down every year that the law has been in effect.

That’s a major reason the Massachusetts plan provokes little controversy today and enjoys the support of a large majority of the state’s population.

A recent study by the Urban Institute, a nonprofit policy think tank, predicted a similar result of about two percent under the federal health reform law. (Assuming, of course, that the Supreme Court lets the mandate take effect when it rules on the law later this month.) (Click here to read the report.)

That’s hardly the pervasive intrusion on our liberty seen by some health reform opponents.

The small percentage should not come as a surprise. The Urban Institute report found that 94 of Americans would be exempt from the mandate entirely. Many of the rest would easily avoid the penalty that would be imposed for violating it. 

Most Americans already have health insurance through their job or through a government program. They will barely even notice that the mandate has taken effect. Millions more with preexisting medical conditions will jump at the newfound opportunity to purchase individual insurance policies, which would be unavailable to them without the law.

Among those who still don’t have health insurance, many will avoid the mandate’s penalty because of financial hardship or religious exemptions. Others earn too little to pay income tax, so there would be no way for the government to collect the penalty from them.

All told, that leaves only about one or two percent of the population actually exposed to the mandate’s penalty. 

There are many grounds on which the Obama health reform law can be fairly criticized. Imposing an unprecedented burden on our liberty is not one of them.

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Check Up covers regional health news and a wide array of healthcare topics from pharmaceutical happenings to patient safety. Read about some of our bloggers here.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Michael R. Cohen, R.Ph. President, Institute for Safe Medication Practices
Daniel R. Hoffman, Ph.D. President, Pharmaceutical Business Research Associates
Hooman Noorchashm, M.D., Ph.D. Cardiothoracic surgeon in the Philadelphia area
Amy J. Reed, M.D., Ph.D. Anesthesiologist and Surgical Intensivist in the Philadelphia Area
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