GAO Report Provides Nine Alternatives to Individual Mandate
On Friday, the Government Accountability Office released a report that provides nine alternatives to the federal health reform law's individual mandate, in the event that the provision is repealed by the Supreme Court, The Hill's "Healthwatch" reports (Pecquet, "Healthwatch," The Hill, 3/25).
Beginning in 2014, the individual mandate in the health reform law requires that nearly every U.S. resident purchase health insurance or pay a penalty. However, it has faced numerous court challenges questioning its constitutionality. Two federal judges already have ruled against the provision, while three have ruled in favor of it (California Healthline, 2/10).
The report, which was requested by Sen. Ben Nelson (D-Neb.) last year, does not endorse or evaluate the effectiveness any of the alternatives, which were provided by 41 health care officials from 21 organizations (Daly, Modern Healthcare, 3/25).
Individual Mandate Alternatives
The nine alternatives proposed in the report are:
- Modify open enrollment periods and impose penalties for late enrollment;
- Facilitate auto-enrollment for employer-sponsored health coverage;
- Conduct a public education and outreach campaign;
- Provide broad access to personalized help with health coverage enrollment by creating access points such as pharmacies, schools and grocery stores;
- Impose a tax to pay for uncompensated care;
- Allow greater variation in premium rates based on the enrollees' age to get more young and healthy people to sign up;
- Restrict access to some federal benefits to people with insurance;
- Pay insurance agents and brokers a flat fee rather than commissions to help people enroll; and
- Require or encourage credit-rating agencies to factor in insurance status in credit ratings ("Healthwatch," The Hill, 3/25).
A spokesperson for Nelson said that he has no immediate plans for legislation on the issue but that eventually some action should be expected.
Sen. Kay Bailey Hutchinson (R-Texas) and 36 other Republicans have backed a bill to delay implementation of the overhaul until the Supreme Court rules on the individual mandate (Modern Healthcare, 3/25).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.