The tax legislation enacted in December 2017 repealed the tax penalty associated with the individual mandate—the Affordable Care Act (ACA) requirement that people who do not qualify for an exemption obtain health insurance coverage—effectively repealing the mandate itself. Understanding how the mandate has affected insurance coverage is important for predicting how insurance coverage and insurance markets, particularly the individual health insurance market, are likely to evolve in the coming years.
But how the mandate has affected insurance coverage remains controversial. Most formal analyses, including those produced by the Congressional Budget Office (CBO), conclude that the individual mandate substantially increased insurance coverage and, correspondingly, that repealing the mandate will substantially reduce coverage. But some, including the Trump Administration and Congressional Republicans, have argued that the mandate has had little or no effect on insurance coverage. In “How Did the ACA’s Individual Mandate Affect Insurance Coverage? Evidence from Coverage Decisions by Higher-Income People,” Brookings’ Matthew Fiedler presents evidence that the ACA’s individual mandate did indeed cause substantial increases in insurance coverage.
A blog post summarizing the findings is here.