Kaiser Health News January 6, 2020
Rachel Fehr and Cynthia Cox

The elimination of the individual mandate penalty raised concerns that healthy enrollees would leave the individual insurance market, insurers would in turn raise premiums significantly, and the market would enter a “death spiral”. The impacts of the mandate penalty repeal are particularly relevant to a pending federal court case, Texas v. U.S., in which plaintiffs seek to strike down the entire Affordable Care Act (ACA) based on the argument that the mandate is unconstitutional without a penalty and is not severable from the rest of the ACA.

Going into 2019, insurers reported that the reduction of the penalty to $0 drove premiums up by about 5 percentage points. Nonetheless, premiums were largely steady in 2019, on average, in part because insurers had priced too high...