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Expert Voices: The Role of Individual Mandates in Health Reform

Jonathan Gruber, PhD, Professor of Economics, Massachusetts Institute of Technology
 

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January 2009

With 46 million people uninsured in America, providing access to health care for all has been touted as a critical goal for health reform in the new Administration. The role that individual mandates may play in the path towards universal coverage has been fiercely debated. Massachusetts legislated a mandate for adults in 2006, and an individual mandate features prominently in several national reform proposals. Despite broad attention being paid to the topic, much of the discussion of mandates has occurred without thorough consideration of the evidence. In this essay, Gruber explores the primary arguments for and against individual mandates and the challenges faced in their design and implementation. Then pulling strongly from the Massachusetts experience, he examines evidence on the effectiveness of individual mandates in practice.

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