There are several reasons why mandatory insurance, contrary to Obama's promises, has been accompanied by rapidly escalating costs. First, when you subsidize something, people tend to consume more of it. Total spending is therefore bound to be higher, whether it's covered through direct taxes or through the indirect tax of forcing people to pay for insurance they don't want.
Second, despite stricter penalties, Massachusetts seems to be experiencing adverse selection. Cannon notes that, while the share of residents without insurance has shrunk from about 10 percent to about 5 percent, the proportion of uninsured people in the 18-to-25 age group has increased from 30 percent to 35 percent, indicating that "the young (and presumably more healthy) are less likely to comply with the mandate."
Third, requiring people to buy insurance entails defining the minimum level of coverage, which necessarily makes insurance more expensive than it would otherwise be. In effect, the government prohibits the cheapest insurance plans, the ones with the highest deductibles and the least generous benefits.
Defining one minimum medical package for the entire country, thereby inviting every health care interest to descend upon Capitol Hill and lobby for inclusion, will compound the inflation caused by state requirements. Cannon warns that such a federal standard could force 100 million Americans into more expensive plans while effectively banning the money-saving combination of high-deductible insurance and health savings accounts.
The upshot is a phenomenon we have seen many times before: Instead of protecting us from big business, big government buys it off with our money.