akenaton The legislation has a number of provisions. That mandate is one of them. It would be more accurate to say that if you can afford it you will pay a fine. It was a compromise. Other provisions are things like no refusal of coverage for pre-existing conditions, coverage of youths on their parents' plans until 26 years old and other consumer focused provisions. Requiring health insurance companies to spend 85% of revenue providing health care. There ware also provisions for computerized records sharing and other cost saving measures.

I think it has had a positive impact on reducing overall health care costs as insurance companies have started to comply with the regulations.

It is not NHS for sure, but since Gov Romney implemented a very similar plan in Mass. The effects seem to have been positive. It is likely to be even better with the economies of scale of a national program.

Our health care system is so badly broken that any steps to improve are going to be better than the status quo. We spend twice as much per person as Canada. Canada has 100% insurance coverage. The US has less than 80% coverage. SOMETHING needed to be done.