Mandatory And Guaranteed Issue Health Insurance

The health insurance industry is supporting reform that would require them to cover everyone, without regard for medical history, as long as the reform includes a provision that everyone must buy into the health insurance system.  It’s easy to see the logic in their position.  Without a mandate, the population that chooses to purchase health insurance under a system with no medical underwriting will always be skewed towards the unhealthy side (which will drive premiums higher no matter how you crunch the numbers). That’s because those who currently need medical care will see the value in health insurance, whereas those who are currently healthy might see health insurance as a waste of money. Especially if they know that they can be accepted later on if they do get sick. I’ve written about mandatory health insurance and made it clear that I believe that in order for the system to work well, everyone has to contribute.

If you look at states like NY, where there is a requirement that health insurance carriers accept everyone, but no mandate that everyone have health insurance, the average premium for an individual policy for one person is $388/month.  For comparison’s sake, the average individual health insurance premium here in Colorado – where we do have medical underwriting – is $141.

I believe that the incoming president and congress will be much more inclined to help people pay for health insurance. I think that we’ll see an expansion of SCHIP and Medicaid over the next few years, and possibly subsidies to help keep health insurance premiums in check. But no matter how much they want to help, there’s a bit of a shortage of money in Washington right now. And there are other issues that will likely be viewed as more urgent than health care reform. That doesn’t mean that health care reform is any less important than it was a year ago, but we’re facing all sorts of other problems that need our government’s attention at the moment.

I’m curious to see where health care reform goes, and whether a mandate eventually becomes part of the solution.  Here in Colorado, making health insurance mandatory gained a lot of ground last year with the Blue Ribbon Commission on Health Care, but we haven’t seen any changes yet. My guess is that most states are waiting to see what happens on the federal level before making any decisions on a state level.

About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for,, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

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