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Actuarial Report on Social Insurance

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Estimating the results of legislative proposals to expand health insurance coverage is challenging, partly because there is so little empirical evidence concerning individual people’s responsiveness to health insurance mandates. Since 2007, adults in Massachusetts have been required to have health insurance or face penalties for noncompliance, but it may be too soon to infer the effect of mandates from that experience. Moreover, that experience itself could be unique to Massachusetts. In the absence of direct empirical evidence, research from three different disciplines—health economics, tax compliance, and behavioral economics—provide alternative perspectives on the effect of the mandate on coverage