The most hated piece of Obamacare is the mandate requiring most Americans to get health insurance.  The Republican alternatives on the table may not prove any more popular.  As the GOP weighs elements of a repeal-replace plan, one of lawmakers’ biggest headaches is finding another way to persuade insurers to cover people with pre-existing health care problems. And all of the options under discussion would either raise the uninsured population or run afoul of GOP principles.

large pool of people uncovered

Levying penalties on those who enroll late looks suspiciously like Obamacare’s existing tax penalty.

automatically enrolling people

Continuous coverage

Premium surcharge

Bigger subsidies: The easiest way to eliminate the need for the individual mandate is also the least likely to happen under a Republican Congress: increase subsidies to the point that coverage would prove too attractive for individuals to pass up. That’s essentially how Medicare functions.    Politico 2.8.2107


Pre – Exisiting Conditions pre ACA – Obamacare


If Obamacare’s Preexisting Conditions Requirement Is Rolled Back, 52 Million Americans Could Be Uninsurable

Before the health law, insurers could deny coverage or charge higher rates based on an individual-plan applicant’s health history. If that were true again today, 52 million Americans have a medical condition that could jeopardize their insurance, according to a new analysis.

McClatchy: 52 Million U.S. Adults Have A Medical Condition That Was Uninsurable Before Obamacare, New Study Finds
Some 52 million working-age adults have a pre-existing medical condition that would likely have left them unable to get health coverage before the Affordable Care Act, according to a new analysis by the Kaiser Family Foundation. Millions of others with similar conditions would likely have faced higher premiums, coverage exclusions or coverage limitations because of stiff underwriting standards faced by people buying insurance outside the workplace before the health law was enacted. This individual insurance market had long been problematic for consumers. It was known for high customer dissatisfaction and turnover, high coverage denial rates, lean benefits and premiums subject to frequent increases. (Pugh, 12/12)

The Hill: Study: 52M With Pre-Existing Conditions Could Be Denied Coverage Without ObamaCare
A new study finds that 27 percent of adults under 65 have pre-existing health conditions that could lead to them being denied coverage if ObamaCare were repealed. ObamaCare banned insurance companies from rejecting people because of their pre-existing health conditions, but the study released Monday by the Kaiser Family Foundation found that if pre-ObamaCare rules returned, 52 million Americans could be denied coverage. (Sullivan, 12/12)

Kaiser Health News: Without ACA Guarantees, 52 Million Adults Could Have Trouble Buying Individual Plans
The researchers noted that a large share of those individuals likely get their insurance through their employers, which does not take into consideration prior health issues. But if the health law were repealed and those people lost their health insurance for any reason, they could face problems. (Rodriguez, 12/13)

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