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Health Insurance Mandates

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Your Health Insurance May Not Be As Good As Your State Requires—and It's Perfectly Legal
Massachusetts has a law to ensure ease of access to birth control pills, saying there should be no copays and women can fill a 12-month prescription at once. Infertility care has similar protections. But many health plans don't have to comply with state laws because they are “self-insured.”
Jun 9, 2023

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Understanding the Impact of the Elimination of the Individual Mandate Penalty
Starting in 2019, the Affordable Care Act's individual mandate penalty will be eliminated, effectively ending the law's requirement that most people have health insurance. While declines in coverage and increases in premiums are likely, the magnitudes of these effects are highly uncertain.
Aug 10, 2018
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Four Steps That Could Stabilize the Health Insurance Market
Congress will soon discuss options to stabilize the individual market and ensure that all Americans have access to affordable coverage. Policymakers could encourage enrollment, make targeted investments to lower premiums, fund cost-sharing reductions, and enforce the individual mandate.
Aug 25, 2017
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Repeal-and-Delay Would Make Budget Neutrality for ACA Replacement Difficult
As Congress considers repealing and replacing the Affordable Care Act, it will need to consider how federal budget scoring can affect the fate of legislation. Depending on the ultimate cost of a replacement, finding enough savings to offset costs while maintaining budget neutrality could make it hard to pass a replacement.
Jan 11, 2017
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Can a Continuous Coverage Requirement Produce a Healthy Insurance Market?
A continuous coverage requirement is intended to discourage individuals from waiting until they become sick to purchase insurance. Such a requirement works well in theory to maintain a healthy marketplace, but there is little evidence on how well it might work in practice.
Jan 4, 2017
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Modifying the ACA's Family Subsidy Rules to Help Ensure Affordability
The ACA encourages workers to retain employer coverage by restricting their eligibility for marketplace subsidies. Modifying the policy could help 700,000 people gain coverage and lower spending for 1.6 million who are insured but face high health care costs under current ACA policy.
Jan 12, 2016
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The Ramifications of Repealing the Individual Mandate
As part of its goal of near-universal coverage, the Affordable Care Act requires most Americans to obtain insurance or pay a penalty. Repealing that requirement would significantly reduce health insurance enrollment and cause individual market premiums to rise.
Aug 13, 2015
blog

Five Years of the Affordable Care Act
The Affordable Care Act has officially been part of the U.S. health care landscape for five years. We reflect on the twists and turns that followed its passage and the RAND research that informed debates along the way, and look ahead to the future of the ACA.
Mar 23, 2015
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Checking the ACA's Vital Signs
Despite pervasive challenges associated with the rollout of the Affordable Care Act (ACA), the administration remains optimistic about its fate. Critics, however, have seized upon the recent mishaps as evidence of the ACA's inevitable demise.
Mar 17, 2014
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Employer Mandate Delay II: Nothing to See Here
Amid mounting political pressure and angst in the business community, the Obama administration announced an additional delay in enforcing the employer mandate component of the Affordable Care Act for some firms until 2016. The additional delay will have little impact.
Mar 3, 2014
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Four Questions on Canceled Insurance Policy Fix
David Mastio, Forum editor at USA TODAY, asked RAND's Christine Eibner four questions about President Obama's plan to fix the problem with people getting their insurance canceled.
Nov 15, 2013
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Data Points: Why Delay of the Employer Mandate May Not Actually Mean That Much
The bottom line is that the employer mandate does not provide a large inducement for firms to change their health insurance offerings, but it does raise a substantial amount of money to pay for the ACA's coverage provisions over time.
Aug 29, 2013
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Governors Missing the Point on Medicaid
While a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states, writes Carter C. Price.
Apr 29, 2013
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What Happens Without Individual Mandate?
If the individual mandate were ruled unconstitutional, subsidies and the age structure of premiums should keep enough healthy people in the insurance exchanges to prevent huge spikes in premiums, write Carter C. Price and Christine Eibner.
Mar 21, 2012
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Finally, Presidential Support for the Individual Mandate
Among all the options in the leading Congressional health care reform bills, the individual mandate would do the most to increase insurance coverage, writes Elizabeth McGlynn.
Sep 9, 2009