The RAND Corporation's COMPARE Initiative provides information and tools to help policymakers, the media, and other interested parties understand, design, and evaluate health policies. The COMPARE website presents a range of policy options that allows the user to explore the effects of commonly proposed health care reforms.
This document explores how requiring individuals to obtain health insurance (an individual mandate) would affect health system performance along nine dimensions. An individual mandate would increase the number of people with coverage by 9 to 34 million, depending on the policy's design. Newly insured individuals would have improved patient experience and increased life expectancy. There is little evidence about how an individual mandate would affect waste; it would have no effect on spending, consumer financial risk, the reliability of receiving recommended care, or system capacity. Implementing an individual mandate would be challenging because it is difficult to determine compliance and enforce penalties for noncompliance.
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