A Rawlsian Defense of the Individual Mandate: The "Collective Asset" Approach

The Patient Protection and Affordable Care Act requires individuals to get coverage or pay a fine (or "shared responsibility payment") starting in 2014. This mandate had been at the center of a contentious political and legal debate. Although the Mandate is key to ending discriminations based on pre-existing conditions in the individual insurance market, its constitutionality had been challenged. We argue that the Obama administration's legal argument for the constitutionality of the Mandate by invoking conventional economic categories such as "negative externalities" is inadequate in addressing the economic and moral significance of the Mandate. As an alternative, we suggest a Rawlsian approach. Specifically, we will borrow the Rawlsian notion of "collective asset" to articulate the moral appeal of the Mandate and its social insurance logic.