Without a tax penalty for not purchasing health insurance, 1 in 5 California residents who purchased individual coverage would not have done so in 2017, according to a study published in Health Affairs.
For the study, researchers examined data from a survey conducted among individual market enrollees, both on and off the public marketplace, in California during 2017.
The ACA's individual mandate was eliminated at the beginning of 2019. While 72 percent of enrollees said they would have still bought individual health insurance in 2017 had the penalty been axed, 19 percent said they wouldn't have. Another 8 percent said they were unaware of the mandate.
Study authors found younger enrollees were more likely to forgo individual coverage than their older counterparts: 26 percent of males ages 18-30 said they wouldn't have purchased coverage, compared to 12 percent of males ages 51 and older. Enrollees without chronic conditions were also more likely to bypass coverage compared to those with two or more chronic conditions.
The researchers estimated premiums would increase 4 to 7 percent in California's individual market if these enrollees were absent from the risk pool.
"Eliminating the mandate penalty alone is unlikely to destabilize the California individual market," the study authors said, "but could erode coverage gains, especially among groups whose members have historically been less likely to be insured."
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