ACA Title 1, Sec 1501 . Requirement to maintain minimum essential coverage: “Good” and “Bad” – Basic individual mandate requirement. This provision includes the legal requirement for individuals to maintain health insurance coverage, also known as the “individual mandate.” Congress made the case that health care is delivered and financed in an increasingly national market making it legally “interstate commerce” and extending legislative authority to require health insurance coverage. I personally support this requirement but not for the “interstate commerce” rationale. I believe that everyone should have basic health insurance coverage and should not create an unfunded liability because of their decision to not secure health insurance coverage. I believe that this is necessary to prevent employers and health plans who actively manage employee health care costs for their own populations from experiencing cost shifting from those who unfairly decide not to purchase health insurance coverage. However, I am also in favor of basic catastrophic coverage – for example everyone would be required to have publically provided health insurance that covers annual health care costs between $100,000 and $2,500,000 million each year per individual. I also believe that this coverage should be financed through tax payments for everyone who resides legally in the U.S. The coverage for the first $100,000 annually per individual should then be the responsibility of the individual and should be tax advantaged for everyone. Employers should have clear incentives to offer health insurance coverage to their employees and their family members.

This “first dollar” coverage should be highly competitive and employers would have a clear tax advantage to provide it to employees and their family members.

The annual penalty in 2014 of $96, 2015 of $350 and $750 IN 2016 is way too small to force healthy young adults to purchase health insurance coverage. This will further jeopardize the solvency of insurers and health plans and seriously undermine the implementation of the Law. Bad policy and bad approach to implementation.
Another provision that should be added to the Law under this section is the authorization for the reduction of premium contributions and penalties because of the personal wellness practices of each individual. In the absence of health plan specific wellness criteria a national set of wellness criteria could be used for everyone.

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