R. R. Reid has added an explanation of the 2010 health reform bill to his bestseller “The Healing Of America, A Global Quest For Better, Cheaper, And Fairer Health Care” which was originally published in 2009. To wit:
“As we’ve seen throughout this book, though, the principle of ‘guaranteed issue’ can only work if it is coupled with another rule, the ‘individual mandate’ – that is, the requirement that everybody buy insurance. The insurers need the mandated customer base to have a broad enough risk pool to pay for guaranteed issue. All the other rich countries figures out this connection long ago; the 2010 act marks the first time the United States has coupled these two requirements…
“But there’s a problem in the reform law: The individual mandate is not firmly established. Congress flinched as the idea of setting a strict penalty for people who don’t buy insurance; the result will likely be that many healthy people will choose to dodge the mandate…
“The fate of the individual mandate provision is pivotal. If it fails, then guaranteed issue will fail as well. And that would pretty much cut the heart out of the Patient Protection and Affordable Care Act.”
