One of the big challenges in both expanding the number of Americans with health care coverage and keeping premiums affordable for people with chronic or serious illnesses has been persuading young and healthy adults to obtain policies. Critics argue that the new U.S. tax law has made this task even harder with its elimination of the individual mandate for health insurance, a part of the Affordable Care Act that requires individuals to buy insurance or risk having to pay a tax penalty. But the effect of the mandate on coverage was never particularly impressive.
How to Persuade the Young and the Healthy to Sign Up for Health Insurance
One of the big challenges in expanding the number of Americans with health care coverage and keeping premiums affordable for people with chronic or serious illnesses and preexisting conditions has been persuading young and healthy adults to obtain policies. Critics of the new U.S. tax law argue that this task has been made harder with its elimination of the individual mandate for health insurance, a part of the Affordable Care Act that requires individuals to buy insurance or risk having to pay a tax penalty. But the effect of the mandate on coverage was never particularly impressive. There is an alternative solution: a modified form of high-deductible health plans (HDHP) that pays for high-value services such as primary care visits and evidence-based medications without subjecting them to a deductible. It could both bolster HDHP enrollment and encourage people not to skip essential care. It would retain the best of HDHP principles (choice, spending discretion) with coverage protection for high-value services that would serve to limit the harms of HDHPs (delayed or forgone care).