There are very good reasons for health insurance mandates — or requiring every American adult to have insurance. One reason is simple finances: Insurance companies need a huge risk pool that spreads costs out among the healthy and the not-so-healthy. Getting more people into the risk pool, especially relatively healthy young adults, helps balance out costs, so that insurance premiums won’t become even more expensive.
The other reason is this: Those of us with insurance subsidize those who don’t have it, which makes our costs go up. No healthy adult knows for sure that he or she won’t suddenly become ill or have a terrible accident that results in emergency room care or hospitalization. Because emergency room care is guaranteed, the rest of us must pay for it through our insurance premiums. (Even if hospitals take a loss, they still try to make up the difference.)
But ultra-conservative lawmakers around the country are following Georgia’s lead, determined to challenge the federal government’s right to impose health insurance mandates. Lawmakers in a dozen states, including Minnesota and Arizona, are considering constitutional amendments to prohibit insurance mandates in their states.
Not that they necessarily expect to win. They just see it as another way to score points with a frenzied political base and to make things more difficult for the Obama administration. “States can no more nullify a federal law like this than they could nullify the civil rights laws by adopting constitutional amendments,” said Timothy Stoltzfus Jost, a health law expert at Washington & Lee University School of Law.
Sometimes, I wish it were possible to refuse health care to these theoretical libertarians, who claim they don’t want or need any help from the government. I used to think that when I’d listen to the debate in the Georgia Legislature over requiring motor cyclists to wear helmets: Why don’t we just let them bust their heads open and pay for their own round-the-clock care when they’re seriously injured?
But, in a reasonably compassionate society, that’s not going to happen. So everybody needs to have health insurance.