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Eliminating Individual Mandate Would Come With Strings

Margaret Dick Tocknell, for HealthLeaders Media, January 18, 2012

4. Low interest in HIX, low enrollment, and less subsidized coverage available. Private coverage and Medicaid lose 12.3 million and 3.5 million members, respectively. The number of uninsured grows to 42.2 million and the cost of uncompensated care increases to $61 billion. Without the individual mandate, government spends $26 billion less on healthcare. Employers and individuals see their spending drop by $26 billion and $30 billion, respectively.

If you're opposed to healthcare reform, these are some compelling numbers that appear to make the case to jettison the individual mandate. But here's the deal: it's complicated.

A case in point is the Medicaid Disproportionate Share Hospital payment. A reduction in the DSH payments in the ACA is based on a 45% reduction in the number of uninsured. According to the report, without the mandate, that condition might not be met "in which case there would be no Medicaid DSH savings to the federal government."

Sure my eyes glaze over when I look at all the tables and numbers in the nine-page report, but this is some of the crucial analysis that state governments and Congress need to consider—oops—make that should have considered.

The fate of the individual mandate now sits with nine Supreme Court justices.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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1 comments on "Eliminating Individual Mandate Would Come With Strings"


Todd Madden (1/19/2012 at 6:12 PM)
Saying uncompensated care will drop partly due to Medicaid enrollment increasing is misleading. Medicaid reimbursement is typically well below cost and Medicaid beneficiaries tend to be in poorer health than the average population which increses utilization. It seems more like shell game than anything else. Hospitals will still be cost shifting even more to employers.