Without the requirement that most people buy coverage, the states may be forced to consider adopting their own mandates or seeking other ways to get healthy people to pay into the healthcare system, Politico reported.
If the Supreme Court doesn't forbid insurance companies to charge more or deny coverage to sicker people, insurers may pressure lawmakers even in states opposing the federal mandate to approve state mandates. The insurers could demand individual mandates and threaten to leave states that don't impose them, with the insurers saying they can't make a profit.
If the Supreme Court strikes down the individual mandate and Congress doesn't change the law, the Kaiser Family Foundation's Larry Levitt said, "I think there would a big push at the state level by the insurance industry to get mandates in place."
While opponents of the healthcare law say Congress exceeded its authority in enacting it, Politico says nobody has challenged whether states have authority to adopt mandates, as Massachusetts did in 2006 when Mitt Romney was governor.