Individual Responsibility

Should Congress require that most Americans have health insurance—and that they be subject to penalties if they don’t?

The leading health reform bills in Congress would impose a national individual mandate requiring most Americans to have health insurance. Among the issues in the debate are the following:

  • 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.

This Health Policy Brief examines the debate over the individual mandate, and was published online on September 29, 2009 in Health Affairs.