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Viewpoint |

In Defense of the Employer Mandate Hedging Against Uninsurance

John E. McDonough, DrPH, MPA1; Eli Y. Adashi, MD, MS2
[+] Author Affiliations
1Department of Health Policy and Management, Center for Public Health Leadership, Harvard School of Public Health, Boston, Massachusetts
2Warren Alpert Medical School, Brown University, Providence, Rhode Island
JAMA. 2015;313(7):665-666. doi:10.1001/jama.2014.17658.
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This Viewpoint traces the origins of the Affordable Care Act’s employer mandate provision, delineates its all-important rationale, and discusses the likelihood and consequences of its potential repeal.

After 2 delays, section 1513 of the Affordable Care Act (ACA)—shared responsibility for employers—is finally slated to go into effect on January 1, 2015.1 The so-called employer mandate requires large employers to offer affordable “minimum-value” health insurance to full-time employees and their dependents (to age 26 years) or be subject to annual penalties if at least 1 employee receives premium tax credits for the purchase of individual health insurance via an exchange.1 Designed to maintain employer-sponsored coverage and to offset the public cost of subsidies to eligible employees in need of health insurance, the employer mandate constitutes an important component of the ACA. However, in the wake of the recent midterm elections, this provision is likely to be singled out for repeal by the newly elected Republican-controlled Congress. In this Viewpoint, we trace the origins of the employer mandate provision, delineate its all-important rationale, and discuss the likelihood and consequences of its potential repeal.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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