Reconciling the Massachusetts and Federal Individual Mandates for Health Insurance: A Comparison of Policy Options

As a part of the 2006 Massachusetts health reform, the state implemented an individual mandate to help improve access to affordable, quality health care. The Affordable Care Act (ACA) also includes an individual mandate, which differs in many design components from the Massachusetts individual mandate.

This report, written by Linda J. Blumberg and Lisa Clemans-Cope of the Urban Institute, examines the three policy options for Massachusetts with regard to its individual mandate. The state can eliminate its mandate, maintain the mandate in its current form, or maintain but modify its mandate to be more consistent with the ACA. In comparing the three options, the researchers consider several criteria, including minimizing complexity for residents, maximizing political acceptability, limiting the administrative burden on the state, minimizing impacts on state revenue, and minimizing disruption to the state’s current system, which has effectively increased insurance coverage and ensured a minimum level of benefits across all insurance markets since 2006.