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Photo: Samuel Corum/Anadolu Agency/Getty Images

The Affordable Care Act’s insurance market has not been materially affected by the elimination of the individual mandate penalty — undercutting a key argument in the lawsuit urging the courts to strike down the health care law.

The big picture: Healthy enrollees have not left the market in droves, premiums have not spiked and there has been no market death spiral.

Details: Premiums spiked in earlier years, as insurers figured out the market and anticipated the elimination of the penalty, but are declining by an average of 2-3% in 2020.

  • Healthy people do not appear to have fled the market. ACA enrollees spent fewer days in the hospital in 2019 than in the previous four years.
  • The financial health of insurers participating in the ACA marketplaces is stable, and dramatically improved since the early years of the ACA. 
  • Other elements of the ACA, such as the Medicaid expansion, appear to have been largely unaffected by the elimination of the penalty.

Flashback: ACA historians will remember that many critics of the mandate believed the penalty was too weak to drive the healthy into the marketplaces from the start.

  • And real-world experience has shown that premium subsidies have been more important than the mandate penalty.

There are still well-documented problems in the individual market. 

  • Policies are unaffordable for many people who do not receive subsidies. Deductibles are very high (averaging $4,544 per person for a “benchmark” plan).
  • And insurer participation in some rural areas remains fragile.    

But these problems existed with the mandate penalty in effect.  

  • Experience on the ground has demonstrated that the marketplaces and the larger ACA continue to function, even when “severed” from the mandate penalty.

Go deeper

Rep. Karen Bass launches run for Los Angeles mayor

Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Rep. Karen Bass (D-Calif.) launched on Monday her bid for mayor of Los Angeles.

Why it matters: Bass is a high profile member of Congress. The former chair of the Congressional Black Caucus, she was considered as a potential running mate to President Joe Biden and was a lead negotiator in the recently-ended talks on police reform. Should Bass win the mayoral election, she would become the first female mayor in L.A. history.

Biden administration takes steps to "fortify" DACA

People attend a protest supporting DACA in New York, Aug. 17. Photo: Kena Betancur/AFP via Getty Images

The Biden administration on Monday took additional steps to save the Deferred Action for Childhood Arrivals program despite ongoing legal challenges to the program.

Driving the news: The Department of Homeland Security unveiled a proposed rule designed "to preserve and fortify" DACA, which offers protection from deportation for undocumented immigrants brought to the U.S. as children. The rule is set to formally publish on Tuesday and would give the public two months to submit comments in favor of or against the Obama-era policy.

Dan Primack, author of Pro Rata
2 hours ago - World

Merkel's departure could bring influx of private investment

Christian Democratic Union party chairman and candidate for the federal elections, Armin Laschet, in front of German Chancellor Angela Merkel in Berlin on Sept. 26. Photo: Clemens Bilan/Pool/Getty Images

Angela Merkel's departure from German government may result in a massive influx of private investment.

Driving the news: The center-left Social Democratic Party, led by chancellor candidate Olaf Scholz, clinched a narrow victory in Germany's federal elections. It now will seek to form a coalition government by year-end with the Greens and the Free Democrats.

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