After federal legislators removed the individual mandate to buy health insurance last year as part of their tax reform plan, some states are looking to implement their own mandates. What would America look like with half the states demanding the purchase of health insurance and the other half not requiring it? The Wall Street Journal reports that Americans may find out.
Maryland lawmakers are pursuing a plan to replace the ACA mandate, which requires most people to pay a penalty if they don’t have coverage. States including California, Connecticut, Hawaii, Rhode Island, Washington, Minnesota, New Jersey and Vermont, as well as the District of Columbia, are publicly considering similar ideas.
This push illustrates a shift in the health care battle from Capitol Hill to the states, igniting a surge of activity that could redefine access and coverage for millions of consumers.
The ACA, also known as Obamacare, sought to create a uniform minimum floor for health coverage. It established certain benefits that many health plans had to cover and barred insurers from charging higher premiums to people with pre-existing conditions.
Republicans in Congress failed to repeal the law overall, but in addition to erasing the individual mandate, the Trump administration has been using administrative actions to roll back the ACA’s requirements and give states more control.
That is creating a landscape in which blue states pursue initiatives to keep or expand the ACA, while red states take actions to defang the law and put a conservative stamp on health policy.
Coming years could see a growing gulf on issues such as Medicaid benefits, consumer protections, insurer regulations, and the availability of cheaper, less-comprehensive health plans, health analysts say.
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