Reihan Salam pursues the issue:
Reader Jim Fair kindly pointed me to an important provision in the Massachusetts law that is not present in ACA, as I understand it. The following is from a summary provided by Healthinsuranceinfo.net:
- If you buy individual health insurance through Commonwealth Choice you may face a pre-existing exclusion period. No pre-existing condition exclusion period can be applied unless you have a break of 63 or more days of continuous coverage. Pre-existing condition exclusion periods can last up to 6 months. Commonwealth Choice plans can look back 6 months to see if you actually received care or treatment for a condition. In addition, pregnancy can be considered a pre-existing condition in individual health insurance. Genetic information cannot be considered a pre-existing condition.
- No preexisting condition exclusion period can be imposed if you are HIPAA eligible.
This strikes me as a powerful disincentive to going without coverage that effectively strengthens the mandate.