MANDATORY PURCHASE OF HEALTH INSURANCE BECOMES AN ISSUE

January 11, 2010

The Sacramento Bee -

Michael Sertic, a college senior studying economics, is young and healthy, and he doesn't want the government forcing him to buy health insurance.

He is among a group of people on both the right and the left ends of the political spectrum who object to proposals in Congress that would compel nearly every American to buy health insurance or face a fine.

"I happen to believe it's unconstitutional. Government shouldn't be forcing someone to pay for someone else's health care," said Sertic, 24, a member of Students for Liberty, a club at California State University, Sacramento, that espouses libertarian values.

The so-called individual mandate, a centerpiece of the sweeping effort to overhaul the country's health care system, seemed a nonissue during most of the early debate just months ago, but in recent weeks it has emerged as another obstacle in the effort to pass legislation providing health insurance to millions of Americans who lack it.

Libertarians condemn compulsory health insurance as unconstitutional, while some liberals argue that it would further allow insurance companies to hold consumers hostage to ever-increasing premiums. That's particularly true, they say, if the final health care legislation does not contain a "public option," or government-run health insurance program, that could provide competition to private insurers.

Insurers, though, support the individual mandate. They say they already have made major concessions in the health care legislation, including a requirement that they issue coverage to anyone regardless of medical history.

Mandatory insurance is necessary, they argue, to spread the burden of paying for health services that will surely result from having to cover the country's least healthy.

The individual mandate is just one component of the legislation, which also proposes payroll taxes on employers to help fund subsidies for uninsured people who cannot afford premiums on their own. Proposals in the House and Senate would not require people with extreme financial hardship to buy health insurance.

People who fail to purchase insurance, either through an employer or a proposed government-run insurance marketplace, could be subject under the House bill to a penalty of as much as 2.5 percent of their income. The Senate proposes penalties between $750 and $2,250 a year, depending on income and family size, according to an analysis by the Kaiser Family Foundation.

Some supporters of the health care legislation aren't wild about the individual mandate but say they're willing to accept it to pass a bill that would extend coverage to most of the nation's 46 million uninsured.

Still, insurers aren't satisfied with the legislation, either. America's Health Plans, the health insurance industry trade group, opposes both versions now in Congress.

"None of the current bills do enough to bend the cost curve," said the group's spokesman, Robert Zirkelbach. Insurers want stronger penalties against those who refuse to buy insurance, saying that the business model would fall apart if too many people decline to buy coverage until they get seriously ill.

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