Insurance Reforms

Beginning in 2014, The Affordable Care Act (ACA) requires insurers to accept all applicants regardless of preexisting conditions (guarantee issue) and prohibits insurers from charging people more because of their health status. These reforms are accompanied by a new individual responsibility requirement (e.g., individual mandate) to obtain and maintain coverage, along with subsidies to help eligible consumers purchase coverage. Some have concerns about requiring individuals to obtain health coverage and are calling for a repeal of the individual mandate.

BCBSA believes that it is critical that a repeal of the individual mandate must be accompanied by changes to ACA's insurance reforms, e.g., guarantee issue and community rating. If not, people will wait to buy coverage until they need it, which will make coverage unaffordable for everyone. States that implemented guarantee issue and community rating without an individual mandate have experienced: drastic premium spikes, "healthier" people dropping coverage and fewer health plan choices. A March 2011 Congressional Budget Office (CBO) report predicts that if the individual mandate is repealed, 16 million fewer people would be covered, and premiums in the individual market will be 15-20 percent higher than they would otherwise be under current law.