If the federal government decides to get rid of the Affordable Care Act individual health insurance ownership mandate, maybe it should rethink the objectives for its health reform efforts, state insurance regulators say.

The National Association of Insurance Commissioners (NAIC), Kansas City, Mo., has issued a statement about the matter in response to a U.S. Government Accountability Office report on possible alternatives to using an individual health coverage ownership mandate as a method for controlling adverse selection in the universal health coverage access system that is supposed to be created by the Patient Protection and Affordable Care Act (PPACA).

Republicans are trying to block implementation of PPACA. If the act takes effect as written, health insurers will have to sell coverage to all applicants, no matter how sick the applicants are, with only limited ability to charge more for sicker applicants.