Value of Individual Health Care Coverage Mandates Questioned

By Staff Report

Oct. 27, 2009

Large-scale individual mandates aren’t necessarily the most effective way to get people to enroll in health insurance, a panel of experts said Monday, October 26, during a meeting of the Congressional Health Care Caucus.

Such a mandate, which is under consideration as a component of health care reform, “is problematic in a free society” and wouldn’t necessarily have a 100 percent success rate, said Rep. Michael Burgess, R-Texas, who chairs the caucus.

The Internal Revenue Service, for example, mandates that all citizens pay taxes, “but 15 percent of the population don’t comply,” he said.

To address the problem of people with pre-existing conditions, Douglas Holtz-Eakin, president of DHE Consulting, proposed the idea of portable insurance policies that would offer coverage regardless of employment or medical history, and carry over into an individual’s retirement.

A brief “open enrollment” period when individuals could sign up for guaranteed coverage would be another alternative to a “draconian mandate,” he said.

Janet Trautwein, CEO of the National Association of Health Underwriters, suggested that automatic enrollment, successfully used in 401(k) programs, could be made available through the proposed insurance exchanges in the respective health care reform bills, perhaps coupled with late enrollment penalties.

As a result, insurance pools would grow, “bringing down costs for employers,” she said.

Filed by Jennifer Lubell of Modern Healthcare, a sister publication of Workforce Management. To comment, e-mail

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