Beginning in 2014, the “Individual Mandate” will require virtually all U.S. citizens and legal residents to either have health insurance or pay a tax for not having it. Also beginning in 2014, no one can be denied insurance coverage, or be charged significantly higher premiums, for having pre-existing health conditions. The question I have been pondering is this: “Is it ethical to choose to pay the tax rather than health insurance premiums until the time when one begins to need health insurance?”
For people without a current need for health insurance coverage this strategy will be financially better because the tax penalty will be lower than most (all?) insurance rates. However, insurance rates will become unobtainably expensive if enough people begin to take this approach. (Due to other federal insurance requirements, akin to free contraception, premiums will increase regardless, but this trend would expedite that climb.)
The Supreme Court ruled that the Individual Mandate’s “penalty” is constitutional because it is essentially a tax. Does this mean it is morally acceptable to incur this tax in a way that breaking a law would not be? Is health insurance a social system for helping others that one is morally obliged to support, or is it an economic contract between a customer and a private company which no one should feel obliged to enter into against his or her own interests? My employer already provides for my health insurance coverage (for now) but what should I counsel an uninsured person who faces this decision, and why?