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Actuaries Asked About Alternatives to Health Law’s Individual Mandate

With the individual mandate unpopular with even among the minority that actually favors the new health care law, it is no surprise that, according to the Politco Pulse, everyone in Washington is asking the American Academy of Actuaries about possible alternatives:

Members of the American Academy of Actuaries, in town for Hill and agency meetings, tell PULSE that one of the hottest questions they’ve gotten is what can be done if the individual mandate falls. The answer? “There’s no real silver bullet,” says Tom Wildsmith, the group’s vice president for health issues. But the alternative is likely a package of ideas: open enrollments, waiting periods and penalties for late enrollment, or perhaps only allowing non-covered persons to buy bronze plans, versus the gold plans.

To readers of FDL, most of these alternatives should sound familiar.

I do have two small issues with this blurb claiming there is “no silver bullet.” To begin with, the individual mandate in the new law isn’t actually a silver bullet to begin with. The CBO says it will increase overall coverage, but it will still leave us short of universal coverage. They project millions of people will still not buy coverage and just pay the mandate penalty.

There is a silver bullet: Single Payer

Single-payer health care–Medicare for all–actually is a “silver bullet” that would result in more people being covered than in any system relying on an individual mandate.

If people think full single payer is too radical and want to leave the new law relatively unchanged, you can create an extremely bare-bones public program where you automatically enroll anyone who does have other insurance. This “silver bullet” would also result in getting more people covered than a mandate to buy private insurance.

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Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at