Motivating Americans to Enroll

By Harold L. Pohlman, professor of political science; A. Lee Fritschler Professor of Public Policy; executive director of The Clarke Forum for Contemporary Issues

One source of difficulty with implementation is the 2012 Supreme Court decision that upheld the constitutionality of Obamacare (the Patient Protection and Affordable Care Act) and the individual mandate, which imposes a penalty on anyone who does not have health insurance as of January 2014.

Chief Justice John Roberts chose to interpret this penalty as a tax imposed by the federal government. The implication was that anyone who refused to buy health insurance but paid the tax was in full compliance with the law. Accordingly, the crucial question is whether the penalty is high enough to motivate Americans who don't want to buy health insurance to do so instead of pay the tax. Will people buy health insurance if the penalty is one-third or one-half of what it would cost to buy a minimum health insurance policy?

There is a definite advantage to buying health insurance. It provides access to health services. Paying a penalty to the federal government has no such quid pro quo. If a sufficient number of Americans do not buy these health insurance policies between now and March 2014, Obamacare might not gain the traction it needs to make the system equitable and efficient.

Read more faculty commentary on the Affordable Care Act.

Published October 8, 2013