Commentary: Only an individual mandate will make health care reform

After its symbolic thumping at the polls in Missouri, even some politicians supportive of federal health care reform are questioning the mandate that everyone must purchase insurance.

"It's not something that I think is a great idea that you require this of folks," Missouri Secretary of State Robin Carnahan, the Democratic candidate for a U.S. Senate seat, told a Springfield newspaper. "I think … it’s better to give people incentives to do things than it is to be punitive."

Her Republican opponent, U.S. Rep. Roy Blunt, wants to repeal the entire Affordable Care Act, including the insurance mandate. But he supports restricting insurance companies from denying coverage to people with pre-existing medical conditions.

Ah, but there's the rub. Universally affordable care, especially for sick people, is the sweet spot of health care reform. But nearly all health policy experts think you have to swallow the bitter pill of mandated insurance purchases to get there.

Seven states have tried to ban insurance discrimination based on pre-existing health conditions without requiring participation in insurance plans from healthy consumers. In each instance, the experiment failed miserably.

In Kentucky, nearly all insurers stopped offering policies in the individual market. In Maine, 13 of 18 major insurers ceased issuing new policies, and many providers doubled their premiums in a three-year period. A narrowing of choices and skyrocketing premiums in non-group markets were experienced in New Hampshire, New Jersey, New York, Vermont and Washington.

To read the complete editorial, visit www.kansascity.com.