Health Insurance Mandate May be Eliminated
North Carolina Health Insurance News Update
The North Carolina legislature and senate have approved a bill House Bill 2, called
“Protect Health Care Freedom.” This bill is designed to weaken the well known “Patient
Protection and Affordable Care Act” (PPACA) which was passed into law by the federal
government in March of 2010. NC House Bill 2 would eliminate the penalty for those
without health insurance in North Carolina. Many other states are currently pursuing
similar legislation.

The purpose of the individual health insurance mandate penalty is to encourage more
healthy individuals into the coverage pool. The effect of an influx of healthy new policy
holders would be an overall reduction in the average health insurance rate. Given the
mandated policy benefits prescribed by the PPACA, health insurance prices were
already projected by health insurance companies to increase in 2014, when many of
the provisions become effective. This increase would have been somewhat alleviated
by federal health insurance subsidies received when purchasing insurance through a
state exchange for applicants whose annual income is less than 400% of the federal
poverty level.

Allowing the optional purchase of health insurance will leave many uninsured out of the
market, which will exacerbate the 2014 increase. One of the most powerful strategies
contained in the PPACA, for restraining health insurance premium increases depends
on including this population.  Another important factor in the passing of House Bill 2 is
the rate spread provision of the PPACA.  The premium rate spread requires a minimum
difference between the most expensive and least expensive policies issued by health
insurance companies.  Statistically, older policy holders have higher health insurance
premiums, and this provision will help decrease their rates.  However, the effect on the
opposite end of the spectrum is an increase in premiums for the young and healthy.   
The result will actually be a further decrease in incentive for young policy holders to
have health insurance, driving even more away from the market.

Nationwide, the struggle will continue in many states.  However, in North Carolina,
policy makers have been halted as Governor Perdue vetoed NC House Bill 2 and
explained with the following 3 reasons:
1.That the house bill is contradictory to the US Constitution because it is, “out of
obeyance with federal laws.”
2.That 27 other states were already pursuing this measure, and doesn't need North
Carolinian resources.
3.That there are unintended consequences in the bill that would harm the children's
health insurance as part of the NC Medicaid program, undermines the requirement that
motorists have coverage, and penalizes insured college students.

The NC congress is currently considering if it has the votes required to override the
Governor's veto.

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