The Patient Protection and Affordable Care Act of 2010 (“ACA”) raises numerous policy and legal issues, but none have attracted as much attention from lawyers as Section 1501. This provision, titled “Maintenance of Mini-mum Essential Coverage,” but better known as the “individual mandate,” requires most Americans to obtain health insurance for themselves and their dependents by 2014. 1 We are dismayed that the narrow issue of the mandate and the narrower issue of free riding have garnered so much attention when our nation’s health-care system suffers from countless problems. By im-proving quality, controlling costs, and extending coverage to the uninsured, the ACA means to address many of those problems. And it’s about time. The United States has lower insurance coverage rates and lower life expectancy than most developed countries, and our system does poorly on several di-mensions of quality. Worse still, we spend much more on health care than any other country—$2.5 trillion, or 17.6 percent of gross domestic product, in 2009.2 These measures of total spending mask grave distributional con-cerns: 52 million people went without insurance during some part of 2010.


Health Law and Policy | Law

Date of this Version