MARIO LOYOLA, RICHARD EPSTEIN & ILYA SHAPIRO
...In fact, implementing those other core provisions without the mandate is likely to result in a financial meltdown. The reason lies in the unyielding economics of health insurance, which the policy reforms at the heart of ACA sought to reshape...
...The ACA’s guaranteed issue provision does nothing to encourage healthy people to pay for “insurance”; on the contrary, it is a powerful incentive for people to wait until they are sick to buy it. That behavior leads to the “adverse selection spiral” under which people buy health care insurance only when they know it is worth more to them than what they pay for it. As healthy people leave the rolls, the per-unit cost of insuring the remaining (riskier) insured rises, which pushes premiums up, which in turn drives more healthy people off the rolls. In the end, the only people who enroll are those with known medical conditions, such that premiums approach the actual cost of health care, and the insurance industry collapses...
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