Beginning in 2014, the Affordable Care Act of 2010 (ACA) requires most Americans to have health insurance or face financial penalties.
The individual mandate, an integral part of health reform, has nevertheless become enormously controversial. Supporters say the mandate is necessary to ensure that nearly all Americans have health care access and coverage and to help keep insurance premiums and government costs stable.
Studies show the mandate will reduce the number of uninsured Americans, lower premiums for people buying insurance in the individual and small-group markets, and reduce the government's cost of subsidizing coverage for newly insured individuals.
Opponents see the mandate as a financial burden and an unconstitutional encroachment on individual liberty.
Suggested alternative approaches have appeal but are expected to be less effective and potentially more costly to the government than the individual mandate.
This Health Policy Snapshot, published online in January 2012, examines how the individual mandate works under the ACA and its cost implications.
Read more from RWJF's Health Policy Snapshot series.