Expanding Health Coverage Without the Individual Mandate


The end of the individual mandate penalty in 2019 and the Trump administration’s promotion of short-term health plans are among recent policy changes that could significantly erode people’s ability to find affordable, comprehensive coverage in the individual insurance market.

In a new Commonwealth Fund report, RAND researchers examine several options for making health insurance more accessible to Americans who shop for their own coverage. These include increasing the generosity of premium tax credits, extending credits to people with higher incomes, and expanding the availability of reinsurance, which helps insurers cover high-cost claims. Analysts Jodi Liu and Christine Eibner find the changes could increase enrollment to 400,000 to 3.2 million people.

While these policies generally involve higher costs, an expanded reinsurance program funded through a fee on health plans could reduce the federal deficit, the authors say.

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