Keith Marzilli Ericson

Professor of Markets, Public Policy, and Law at Questrom School of Business, Boston University


An individual mandate, or a tax? How policy is articulated matters.

Under the Affordable Care Act, people must buy health insurance  or pay a financial penalty. Framing that policy as a mandate to buy health insurance versus as a tax on not purchasing health insurance can matter.

In Ericson and Kessler (JEBO 2016), we describe the results of a year-long experiment in which a series of participants reported their probability of purchasing health insurance either under a mandate or a financially equivalent tax.

In late 2011 and early 2012, articulating the policy as a mandate, rather than a financially equivalent tax, increased probability of insurance purchase by 10.6 percentage points — an effect comparable to a $1000 decrease in annual premiums. However, the controversy over the Affordable Care Act’s insurance mandate provision that changed the political discourse during the year 2012. We document the rise of this controversy. After the controversy, the mandate is no more effective than the tax.

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