A world without an individual mandate
Health economist Jon Gruber runs the numbers on a world in which the individual mandate is struck down and not replaced by anything:
-Repeal of the requirement to buy insurance would mean more people would wait until they get sick to buy insurance in the new nongroup exchanges, which would increase the average premium by 27 percent in 2019.
-Retaining the law’s insurance reforms, but repealing the subsidies as well as the requirement to purchase insurance, would further discourage people from buying insurance when they’re healthy. Premiums in 2019 would cost twice as much as projected under the law as a result.
-Retaining the law but repealing the mandate would newly cover fewer than 7 million people in 2019 rather than the 32 million projected to be newly covered by the law. Federal spending, however, would decline by only about a quarter under this scenario since the sickest and most costly uninsured are the ones most likely to gain coverage.
-Retaining only the insurance reforms in the law -- repealing both the mandate and the subsidies -- would not increase the number of people with insurance, leaving 55 million people uninsured in 2019.
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