The Affordable Care Act provides some of the most sweeping health care reform laws in the last several decades, and although many of these laws won't take effect for several years, the ACA has already become a controversial piece of legislation. The so-called "health insurance mandate" in the Affordable Care Act has probably sparked the most debate. It puts a tax in place for families and individuals who don't purchase health insurance, with subsidies for low-income individuals who may not be able to afford health insurance on their own. The health insurance mandate is opposed by many free market Republicans, but it's an essential part of the ACA. Health insurance companies lobbied strongly to include the mandate as a part of the bill.

The main reason that health insurance companies insisted on the mandate was to increase the pool of insurance buyers in the United States. With more people buying insurance, it will be easier for the insurance companies to provide coverage to all Americans, including those with preexisting conditions (whose coverage is also mandated by the Affordable Care Act). The mandate will provide a necessary drop in insurance costs for all U.S. buyers. This is particularly important, because many other aspects of the Affordable Care Act are expected to increase the average cost of an insurance policy. The health insurance mandate provides a counterbalance, preventing insurance rates from skyrocketing.

Many ACA supporters have also noted that the health insurance mandate will likely decrease the cost of health care overall. When the majority of United States citizens have insurance policies, they'll seek treatment earlier. This is crucial, because early treatment of a disease or condition often decreases the overall cost of treatment significantly. Individuals will get faster care, which will lower the cost of the average health insurance claim while ensuring better health for the average American. There's a debate as to the extent of this effect, but statistics indicate that insurance policy holders are much more likely to seek medical care in the early stages of a disease than uninsured individuals.

There have been legal challenges to the Affordable Care Act, and many are centered on the health insurance mandate. Opponents claim that it's unconstitutional to require health insurance coverage with a tax penalty. Early challenges have been dismissed in court, and as health insurance companies and ACA supporters claim that the bill couldn't exist without the mandate, it's unlikely that the rest of the Affordable Care Act will take effect if the health insurance mandate is successfully contested. In the end, the health insurance companies were reasonable in supporting a mandate, and it's essential to the ACA.