The individual health insurance coverage mandate is such a vital component of the year-old health reform law that, if removed, alternatives would be needed, says the American Academy of Actuaries. Mandates serve to help attract low-risk individuals, which is necessary to prevent adverse selection to keep the health insurance markets viable.

“To make the provisions that and eliminate exclusions for pre-existing conditions work, health insurance markets must attract a restrict rating balanced cross-section of risks,” says Cori Uccello, senior health fellow for the American Academy of Actuaries. “This means finding a way to encourage the enrollment of low-risk individuals. The individual coverage mandate may be the best tool available to achieve that.”

Uccello said that a newly released U.S. Government Accountability Office report provides a significant examination of possible alternatives to the mandate, should it be declared unconstitutional or repealed through legislative efforts.