The Washington Post did an analysis on the state of Washington that had a law guaranteeing all residents have access to private health-care insurance, regardless of their health, and requiring them to purchase coverage. That was in1993. Two years later, the state legislature repealed just the mandate part. So, in essence, this example would be a good study case of what would happen if the Supreme Court does the same to the Affordable Healthcare Act ‘s mandate. So what happened almost 20 years ago? Well, the guaranteed-access provisions still stood but the state saw premiums rose and enrollment dropped. Health insurers fled the state and, by 1999, it was impossible to buy an individual plan in Washington as no company was selling. Ouch. “There are seven states that tried this in the mid-1990s and, in every case, it was a disaster,” said MIT health-care economist Jonathan Gruber, who worked on Massachusetts’ health-insurance law and the Affordable Care Act. To summarize, if the mandate fails, this whole law may be a really, really bad thing. Don’t get me wrong. There actually are some parts of it that I like. My 20 year old son gets to be on my insurance. Hooray. But it looks like it is back to the drawing board. If they have to redo it, they may want to think about paying primary care doctors more (to get medical students interested), NOT increasing the Medicaid roles (a smoke and mirror trick of this law) and putting in some tort reform. Just sayin’.
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