According to an analysis by the Los Angeles Times, the Republican plan to repeal Obamacare's individual mandate with their tax reform legislation will likely throw off insurance markets in conservative, rural areas of the country. The result could be entire states - including Alaska, Iowa, Missouri, Nebraska, Nevada and Wyoming - with either no health care options or premiums priced so high they are out of reach for most Americans.
There are 454 counties nationwide with only one health insurer on the marketplace in 2018 and where the cheapest plan available to a 40-year-old consumer costs at least $500 a month. Markets in these places risk collapsing if Congress scraps the individual insurance mandate.
Republicans have argued that repealing the individual mandate will save many Americans money by eliminating the penalty for being uninsured.
“The individual mandate isn’t just any tax. It’s a terribly regressive tax that imposes harsh burdens on low- and middle-income taxpayers,” Senate Finance Committee Chairman Orrin G. Hatch (R-Utah) said as his panel debated the tax bill this month. "Zeroing it out means we have a chance to provide greater tax relief to middle-class families, through both reduced penalties and lower overall rates."
But experts generally disagree with this synopsis, arguing that:
...eliminating the mandate without some other mechanism to encourage young, healthy Americans to get coverage could have disastrous consequences for the individual insurance market, which serves consumers who don’t get coverage through an employer or a government plan such as Medicare or Medicaid.