Reply #148: Many folks buy now because they know once they get sick, no insurer will cover them. [View All]

[Hoyt]

In 2014, insurers can't deny coverage for pre-existing conditions -- including Medicare if it were a public option. So, there will be no "security" incentive for purchasing insurance until you really need it the next day. You and I might purchase it anyway (assuming we have the funds), but a lot of folks won't or just can't. Point is, a mandate is all but required or a significant percentage of people will wait -- increasing premiums for those who do purchase.

Right now, you don't have to take Medicare Part B if you don't want it. But, if you suddenly decide you want it (like when you get really sick), you have to wait until the annual open enrollment period and usually pay a higher premium. There are some exceptions if you are employed and take your employer's insurance over Medicare Part B when you become eligible (which obviously saves "Medicare" money).