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Obamacare Can Live Even If the Mandate Dies

One tack: Give people tax credits if they buy insurance
Obamacare Can Live Even If the Mandate Dies
Illustration by 731, Tombstone: Fotosearch/Getty Images, Hand: Katherine Fawssett/Getty Images

Judging from the skeptical questions posed by justices last month, there’s a real chance that the Supreme Court will strike down the central provision of the Affordable Care Act: the mandate that individuals carry health insurance. Without it, the Obama administration says, some healthy people will forgo coverage, which will force insurers to raise premiums on everyone else, thus prompting even more people to drop out of the insurance pool until only the sickest and costliest remain—a spiral to the death for so-called Obamacare.

Getting everyone or nearly everyone to pay in is essential for financing the key protections of Obamacare: the requirement that insurers cover all comers, and that they do so without charging extra for costly preexisting conditions. Yet work being done by economists, health policy experts, and lobbyists suggests there may be alternatives to the individual mandate that would rope healthy people into buying insurance in ways that don’t attract legal challenges.