Several health insurance reform plans, including the recently enacted Massachusetts plan, envision the use of individual or employer mandates to increase coverage rates. In this paper we summarize and analyze existing evidence on the effectiveness of mandates, drawing on evidence both from health insurance and from other arenas where mandates are often used. We find that mandates can, but do not always, increase participation in programs. The effectiveness of a mandate depends critically on the cost of compliance, the penalties for noncompliance, and the timely enforcement of compliance.
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