Excerpt from National Review
The president has another reason for favoring compulsion. He seeks regulations on the insurance industry that will not work unless people are forced to buy its products. If insurers have to charge the same price to all comers regardless of their health status, healthy people will have no reason to sign up. They will instead wait until they get sick and get charged the same rate. But if only sick people buy insurance, premiums will skyrocket. Insurance markets will collapse.
An order for all people to buy insurance would not so much prevent that collapse as disguise it. Once insurance companies have to sell policies to sick people and healthy people at the same rates — or to put it another way, once people are no longer allowed to buy insurance policies that give them a discount for being healthy — those policies are no longer insurance against the risk of getting sick. What “insurance companies” would instead be selling is a share of the nation’s medical resources. Viewed from this angle, the same need for compulsion presents itself. If you think that you are likely to cost less than your share of the nation’s medical expenses, and you have freedom, you may reject this bad deal. But if only the people who expect they will have higher than average medical expenses take the deal, again, the system becomes untenable. The president wants insurance to be structured in a way that cannot arise in conditions of freedom. Hence those conditions must be revoked.