Florida has two lines of argument in its legal challenge of the federal health reform law — one against the expansion of Medicaid, and one against the requirement that individuals purchase health insurance.

The so-called individual mandate is seen as the unpopular policy that allows for the popular parts of health care reform, like preventing insurance companies from denying coverage based on pre-existing conditions.

This week, with six new states joining Florida’s lawsuit, Kaiser Health News rounded up a range of health policy experts to talk about the mandate. Is there a viable Plan B?

A few of the points they make:

  • In its current form, the individual mandate may be too weak to meet the goal of bringing enough healthy, profitable people into the insurance market to cover for the more expensive patients, like those with pre-existing conditions.
  • There are alternatives to the mandate — other incentives and penalties, such as open-enrollment periods. If people with pre-existing conditions don’t sign up during those periods, they could be denied coverage or charged higher premiums.
  • Several analysts worry those options might not be strong enough. Robert D. Reischauer, president of the Urban Institute, sums up this perspective: “The Democrats should stick with the policy that they and virtually every health care expert have said is the most effective way to cover the uninsured while holding down the growth of costs. All the other policies are distant second bests.”
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