Health Affairs/RWJF Health Policy Brief Series

Highlighting key issues in health reform.

Should Americans Be Mandated to Carry Health Insurance?

In: Health Affairs/RWJF Policy Brief Series

Publisher: Health Affairs/Robert Wood Johnson Foundation

Published: September 29, 2009

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The leading health reform bills in Congress would impose a national individual mandate requiring most Americans to have health insurance. This Health Policy Brief explores:

  • the background of individual mandates;
  • the technical aspects that still need to be agreed upon such as coverage standards, out-of-pocket costs, purchasing exchanges, government subsidies and penalties;and
  • the arguments on both side of the issue.

Supporters of an individual mandate argue that it is key to having America’s public-private health care system function as effectively as possible because these systems work best when everyone is insured. They contend that there would be enough resources to help individuals comply. Opponents of the individual mandate argue that it would be an infringement by government on personal freedom, that it’s unreasonable to compel people to buy insurance that they consider unnecessary, and that it would be overly burdensome on many people. Opponents also question how such a mandate would be implemented and whether there is a need for it.


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