Most health policy experts say that the individual mandate in order for insurers to able to accommodate these customers. As the Obama administration has to the court, without an individual mandate, the provision barring insurers from discriminating against those with pre-existing conditions can "create a spiral of higher costs and reduced coverage because individuals can wait to enroll until they are sick." Should the Supreme Court decide to strike down the individual mandate, the administration has asked the court to strike down the pre-existing conditions provision as well.

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