The Democratic requirement is based upon the fact that it is necessary for healthy individuals who might not feel pressured to buy health insurance (like young people who feel immortal) to balance out the overall risk pool for insurance companies, which will act to defray costs. While the Republicans denounce the Democratic proposal as job killing, the Democratic proposal brings up the fact that many people who make too much money to participate in Medicaid have no insurance, because their employers do not provide them with it and they are too poor to pay for expensive monthly premiums. What kind of an America, one might ask, is it, where people can work hard, yet feel threatened by the risk of medical bankruptcy if they go to the Emergency Room when they are extremely ill?
Another difference between the two proposals is that the Republican plan allows people to buy health insurance across state lines. This means that insurance companies that offer bare bones coverage at discounted rates will likely have more individuals in their risk pool. However, because these low cost insurance programs do not provide as much high-quality coverage, this will effectively mean that insurance programs will be rewarded if they do not encourage people to obtain valuable preventative screening care.
One problem with health insurance is that people are not willing to pay for it unless they are ill and the costs of their treatment with insurance would be lower with than without insurance.
People who are uninsured and ill are more willing to seek out coverage than people who are healthy, but insurance companies do not want to insure bad risks. The solution is to require even young, healthy people to enter the risk pool, defraying overall costs of care and placing restrictions on insurance companies (like banning people from rejecting individuals with preexisting conditions) to ensure expanded coverage to the sick and the well. This fundamentally sound principle is at the heart of the Democratic initiative..